Prior to 2019, the majority of patients at Children’s Hospital Colorado were admitted to the pediatric intensive care unit (PICU) following Chiari malformation (CM) decompression surgery. This study sought to identify the safety and efficacy of postoperative general ward management for these patients.

After a retrospective baseline assessment of 150 patients, a quality improvement (QI) initiative was implemented, admitting medically noncomplex patients to the general ward postoperatively following CM decompression. Twenty-one medically noncomplex patients were treated during the QI intervention period. All patients were assessed for length of stay, narcotic use, time to ambulation, and postoperative complications.

PICU admission rates postoperatively decreased from 92.6% to 9.5% after implementation of the QI initiative. The average hospital length of stay decreased from 3.4 to 2.6 days, total doses of narcotic administration decreased from 12.3 to 8.7, and time to ambulation decreased from 1.8 to 0.9 days. There were no major postoperative complications identified that were unsuitable for management on a conventional pediatric medical/surgical nursing unit.

Medically noncomplex patients were safely admitted to the general ward postoperatively at Children’s Hospital Colorado after decompression of CM. This approach afforded decreased length of stay, decreased narcotic use, and decreased time to ambulation, with no major postoperative complications.

2019 年之前，科罗拉多儿童医院的大多数患者在 Chiari 畸形 (CM) 减压手术后被送往儿科重症监护病房 (PICU)。本研究旨在确定这些患者术后普通病房管理的安全性和有效性。

在对 150 名患者进行回顾性基线评估后，实施了质量改进 (QI) 计划，在 CM 减压术后将医学上不复杂的患者收入普通病房。在 QI 干预期间治疗了 21 名医学上不复杂的患者。对所有患者的住院时间、麻醉剂使用、下床行走时间和术后并发症进行了评估。

实施 QI 计划后，PICU 术后入院率从 92.6% 下降至 9.5%。平均住院时间从 3.4 天减少到 2.6 天，麻醉给药总剂量从 12.3 天减少到 8.7 天，下床时间从 1.8 天减少到 0.9 天。没有发现不适合在传统儿科医疗/外科护理单位进行管理的重大术后并发症。

CM 减压后，医学上不复杂的患者在科罗拉多儿童医院术后安全地进入普通病房。这种方法缩短了住院时间，减少了麻醉药的使用，缩短了下床时间，并且没有出现严重的术后并发症。