SECTION D: PEDIATRIC GASTROENTEROLOGY
D1.Do you have a Pediatric Gastroenterology program?
Yes
No – Skip to Section E
When responding to questions in this section, your hospital must consult with the chief of service (or equivalent) of your Pediatric Gastroenterology program to ensure that answers are accurate and consistent with both the care delivered and the intent of the survey.
As data are reviewed, U.S. News may have questions about responses to individual questions or about an entire submission. To ensure communication with the appropriate clinical leader, please provide the following information about the chief of service (or equivalent) for your Pediatric Gastroenterology program.
Full name:
Title:
Email:
Preferred phone:
REQUIRED: IF NAME, TITLE, EMAIL, OR PHONE=BLANK, DISPLAY: “A response is required for [Name/Title/Email/Phone] prior to submitting the survey. Click “OK” to continue with the survey and answer this question later. Click “Cancel” to provide a response to this question now.”
D2.Please indicate the total number of attending/on-staff physicians (excluding fellows)[1] who are currently members of the medical staff in your Pediatric Gastroenterology program in the following categories. For each category, please also indicate the total number of full-time equivalents (FTEs)[2] devoted to clinical care.[If none, please enter 0.]
Total Physicians / Clinical FTEsa. / Pediatric gastroenterologists (board certified/board eligible by the American Board of Pediatrics with subspecialty certification in pediatric gastroenterology) / ______/ ______
b. / Other attending/on-staff physicians (include all other attending/on-staff physicians who are not subspecialty board certified/board eligible in pediatric gastroenterology) / ______/ ______
VALIDATE: IF D2x1 IS NOT A WHOLE NUMBER, DISPLAY: “D2x (Total Physicians): Please enter a whole number (no decimals).”
D2.1. Does your hospital have at least one pediatric surgeon (board certified/board eligible by the American Board of Surgery with subspecialty certification in pediatric surgery) available 7 days a week?
Yes – Go to Question D2.2
No – Skip to D3
D2.2. What is the total number of full-time equivalents (FTEs)[3] of pediatric surgeons (board certified/board eligible by the American Board of Surgery with subspecialty certification in pediatric surgery) that support your Pediatric Gastroenterology program?[If none, please enter 0.]
______FTE
VALIDATE: IFD2.1=YES AND D2x= 0, DISPLAY: “D2.2: If none, please answer No to D2.1.”
Note: The preceding questions are used to determine eligibility for Pediatric Gastroenterology. If you leave any part of these questions blank, your hospital will be considered ineligible for the rankings in Pediatric Gastroenterology.
D3.Please indicate the total number of nurse practitioners and physician assistants whowork in or directly support your Pediatric Gastroenterology program. For each category, please also indicate the total number of full-time equivalents (FTEs)[4] devoted to clinical care.[If none, please enter 0.]
TotalStaff / Clinical FTEs
a. / Nurse practitioners / ______/ ______
b. / Physician assistants / ______/ ______
VALIDATE: IF D3x1 IS NOT A WHOLE NUMBER, DISPLAY: “D3x (Total Staff): Please enter a whole number (no decimals).”
D4.Please indicate the number of clinical nurse (RN)FTEs[5]whowork in or directly support your Pediatric Gastroenterology outpatient program. [If nursing staff are shared between departments, only include the portion of time spent caring for pediatric gastroenterology patients.][If none, please enter 0.]
______FTE RNs
D5.Please report the total number of Pediatric Gastroenterology outpatient visits (excluding visits for procedures or visits for clinical testing or infusion therapy) for your program in the last calendar year.[If none, please enter 0.]
______Outpatient visits excluding procedures
VALIDATE: IF D5 IS NOT A WHOLE NUMBER, DISPLAY: “D5: Please enter a whole number (no decimals).”
D6.What was the average “third next available” appointment time[6] for new patients in your Pediatric Gastroenterology program, to receive an appointment for an outpatient office visit in the last calendar year?[Calculate the average over the entire reporting period.]
______Average days to “third next available” appointment
NA, data for “third next available” are not available
D7.Does your hospital provide the following technologies or services to pediatric inpatients on-site?
Yes / Noa. / Magnetic resonance cholangiopancreatography (MRCP)[7] / ○ / ○
b. / Magnetic resonance enterography[8] / ○ / ○
c. / DXA scan / ○ / ○
d. / Ultrasound elastography (USE) for assessing liver fibrosis / ○ / ○
e. / Magnetic resonance elastography (MRE) for assessing liver fibrosis / ○ / ○
D8.For patients in your Pediatric Gastroenterology program, are the following specialists available for consultation 7 days a week?
Yes / Noa. / Pediatric gastroenterology/liver-specialized pathologists[9] / ○ / ○
b. / Interventional radiologists with experience or training in pediatric gastroenterology interventional radiology / ○ / ○
D9.Does your Pediatric Gastroenterology program provide patient/family educational programs[10] for the followingdisease-specific GI conditions?
Yes / Noa. / Inflammatory bowel disease, Crohn’s disease or colitis / ○ / ○
b. / Celiac disease / ○ / ○
c. / Liver disease / ○ / ○
d. / Eosinophilic Esophagitis / ○ / ○
e. / Chronic intestinal failure / ○ / ○
D10.Were the following dedicated[11] interdisciplinary treatment programs offered in your hospital in the last calendar year? To answer yes, each program must a) have the involvement of providers from your Pediatric Gastroenterology program, and b) meet the minimum patient volume requirements listed.
Yes / Noa. / Intestinal rehabilitation program[12] (for patients with short bowel syndrome) with at least 10 patients seen in the last calendar year / ○ / ○
b. / Cystic fibrosis treatment program[13] (including gastroenterologists and nutritionists in treatment team) with at least 10 patients seen in the last calendar year / ○ / ○
c. / Total parenteral nutrition (TPN) support program[14]with at least 10 patients seen in the last calendar year / ○ / ○
d. / Pediatric intensive feeding program[15]with at least 20 patients seen in the last calendar year / ○ / ○
e. / Multidisciplinary childhood obesity management program[16]with at least 20 patients seen in the last calendar year / ○ / ○
f. / Inflammatory bowel disease program[17]with at least 20 patients seen in the last calendar year / ○ / ○
g. / Multidisciplinary allergic gastrointestinal disease program[18]with at least 20 patients seen in the last calendar year / ○ / ○
h. / Chronic liver disease program[19]with at least 20 patients seen in the last calendar year / ○ / ○
i. / Neurogastrointestinal program[20] with at least 20 patients seen in the last calendar year / ○ / ○
j. / Aerodigestive program[21]with at least 10 patients seen in the last calendar year / ○ / ○
k. / Pancreatic disease program with at least 10 patients seen in the last calendar year / ○ / ○
l. / Ano-rectal or Colo-rectal program[22]with at least 10 patients seen in the last calendar year / ○ / ○
D11.Does your Pediatric Gastroenterology program provide the following advanced diagnostic tests or interventional procedures? If so, how many unique patients received the test/procedure and what was the total number of tests/procedures performed on all patients in the last calendar year?
Yes / No / Unique Patients / Total Tests/Procedures
a. / Capsule endoscopy (see code list) / ○ / ○ / ______/ ______
b. / Endoscopic band ligation/sclerotherapy (see code list) / ○ / ○ / ______/ ______
c. / Esophageal impedance or high resolution esophageal manometry (see code list) / ○ / ○ / ______/ ______
d. / Diagnostic or therapeutic endoscopic retrograde cholangiopancreatography (ERCP) (see code list) / ○ / ○ / ______/ ______
e. / Antroduodenal and full colonic motility studies (see code list) / ○ / ○ / ______/ ______
f. / Esophageal dilation, either bougie or pneumatic (see code list) / ○ / ○ / ______/ ______
g. / Alternative Hemostasis Therapies: Electrocautery, Hemo-Clip application, and Argon Laser (see code list) / ○ / ○ / ______/ ______
h. / Deep enteroscopy - single or double balloon(see code list) / ○ / ○ / ______/ ______
WARNING: IF D11x1=“Yes” AND D11x2=(0 OR BLANK), DISPLAY: “D11x: Please check your responses. You marked that you offer these procedures, but reported no patients.”
VALIDATE: IF D11x2 > D11x3, DISPLAY: “D11x: Please check your responses. The total number of patients cannot be greater than the total number of procedures/tests.”
IF D11x2 IS NOT A WHOLE NUMBER, DISPLAY: “D11x2: Please enter a whole number (no decimals).”
D11.1Does your hospital provide the following diagnostic and therapeutic procedures for patients in your Pediatric Gastroenterology program?
Yes / Noa. / Interventional radiology embolization for gastrointestinal bleeding / ○ / ○
b. / Interventional radiology for image guided liver biopsies / ○ / ○
c. / Interventional radiology performance of transjugular intrahepatic portosystemic shunt (TIPS) / ○ / ○
d. / Interventional radiology performance of transjugular (TJ) liver biopsies / ○ / ○
e. / Interventional radiology performance of hepatic vein wedge pressure measurement / ○ / ○
D12.Does your hospital provide or have access to the following support groups in your community for patients and their families?
Yes / Noa. / Inflammatory bowel disease (IBD), including Crohn’s disease and colitis support group[23] / ○ / ○
b. / Celiac disease support group[24] / ○ / ○
c. / Liver disease or transplant support group[25] / ○ / ○
d. / Eosinophilic Esophagitis support group / ○ / ○
e. / Chronic intestinal failure support group / ○ / ○
D13.How many unique patients with the following conditions were seen by your Pediatric Gastroenterology program in the last calendar year? [If none, please enter 0.]
Unique patientsa. / Pseudoobstruction (see code list) / ______
b. / Chronic intestinal failurepatients who require TPN for 2 months or more (see code list) / ______
c. / Chronic liver disease (see code list) / ______
d. / Acute, recurrent, or chronic pancreatitis (see code list) / ______
e / Biliary atresia (see code list) / ______
f. / Portal hypertension (see code list) / ______
g. / Celiac disease (see code list) / ______
h. / Eosinophilic esophagitis (see code list) / ______
VALIDATE: IF D13x IS NOT A WHOLE NUMBER, DISPLAY: “D13x: Please enter a whole number (no decimals).”
D14.Did your Pediatric Gastroenterology program participate in any formal, multicenter initiatives for the following in the last calendar year?
Yes / NoStudies of pediatric liver transplantation (SPLIT), ChiLDREN Network, Pediatric acute liver failure (PALF), or any other formal, multicenter initiative to study liver disease / ○ / ○
Other formal, multicenter initiative for GI disorders (such as NIH’s PROTECT, RISK, Hepatitis B Network, Consortium of Eosinophilic Gastrointestinal Disease Researchers (CEGIR), Peds CORI, INSPPIRE) / ○ / ○
D14.1. If “yes” to D14b, please describe ONE other formal, multicenter initiative. Do not include any initiative already listed in D14a. To receive credit the initiative must be a multicenter (3 or more institutions) initiative and targeted to GI disorders.
D15.Did your Pediatric Gastroenterology program participate in any of the following types of research activities in the last calendar year? If yes, how many trials, studies, or databases[26] did you participate in during this period of time?
Yes / No / Number of trials, studies, and databasesa. / Prospective randomized clinical trial / ○ / ○ / ______
b. / Prospective observational studies / ○ / ○ / ______
c. / Prospective clinical database on patient care / ○ / ○ / ______
d. / Prospective non-randomized clinical trial (i.e., open label trial, single case trials) / ○ / ○ / ______
VALIDATE: IFD15x1=Yes AND D15x2=(0 OR BLANK), DISPLAY: “D15x: Please provide a value greater than 0 for the number of research activities or answer No.”
IF D15x IS NOT A WHOLE NUMBER, DISPLAY: “D15x: Please enter a whole number (no decimals).”
D16.How many IRB approved studies with principal investigators in the Pediatric Gastroenterology program are currently being conducted at your hospital?[If none, please enter 0.]
_____ # of studies
VALIDATE: IF D16 IS NOT A WHOLE NUMBER, DISPLAY: “D16: Please enter a whole number (no decimals).”
D17.How many unique pediatric inpatients had the following procedures[27]in the last calendar year?[If none, please enter 0.]
Unique patientsa. / Hepatoportoenterostomy or Kasai procedure on a patient with biliary atresia (see code list – must have both diagnosis and procedure code) / ______
b. / Bowel lengthening such as Bianchi or serial transverse enteroplasty (STEP) procedures (see code list – must have both diagnosis and procedure code) / ______
c. / Laparoscopic esophagogastricfundoplasty(see code list) / ______
d. / Bariatric surgery (see code list – must have both diagnosis and procedure code) / ______
e. / Posterior sagittal anorectoplasties (Pena) for imperforate anus (see code list – must have both diagnosis and procedure code) / ______
f. / Laparoscopic procedures for Ulcerative Colitis (pouch) and Crohn’s disease (see code list – must have both diagnosis and procedure code) / ______
g / Esophageal atresia repair (see code list – must have both diagnosis and procedure code) / ______
VALIDATE: IF D17x IS NOT A WHOLE NUMBER, DISPLAY: “D17x: Please enter a whole number (no decimals).”
D18.Does your hospital track seasonal influenza vaccination of chronic intestinal failurepatients(from D13b) seen by your Pediatric Gastroenterology program?
Yes – Go to Question D19
No – Skip to Question D20
D19.Of the total vaccine eligible[28] chronic intestinal failurepatients (from D13b) seen by your Pediatric Gastroenterology program between October 1, 2017 and December 31, 2017, what percentage received seasonal influenza vaccine (at your hospital or elsewhere) during that time period or earlier that season?
______%
D19.1How many pediatric transplant hepatologists with the American Board of Pediatrics (ABP) Certification of Added Qualifications (CAQ) certification in transplant hepatology work in this program? [If none, please enter 0.]
______Number of ABP CAQ hepatologists
VALIDATE: IF D19.1 IS NOT A WHOLE NUMBER, DISPLAY: “D19.1: Please enter a whole number (no decimals).”
D20.Does your Pediatric Gastroenterology program have a liver transplant program recognized by the United Network for Organ Sharing (UNOS)? [NOTE: If your hospital is only affiliated with, but is not a UNOS liver transplant program, then you should answer no[29].]
Yes
No – Skip to D23
D20.1This question was moved back to 19.1.
D21.Please report your program’s Pediatric (<18) 1-year liver transplant patient survival statistics from Table C15 in your December SRTR report, which includes transplants performed between 7/1/14 and 12/31/16. [If any elements of the table from SRTR are blank or not applicable, please leave them blank on the survey.]
1-year SRTR measure / Table C15 value- Number of transplants evaluated
- Estimated probability of surviving at 1 year (unadjusted)
- Expected probability of surviving at 1 year (adjusted)
- Number of observed deaths during the first year after transplant
- Number of expected deaths during the first year after transplant
- Estimated hazard ratio
- 95% credible interval (low value)
- 95% credible interval (high value)
D22.Please report your program’s Pediatric (<18) 3-year liver transplant patient survival statistics from Table C16 in your December SRTR report, which includes transplants performed between 1/01/12 and 6/30/14. [If any elements of the table from SRTR are blank or not applicable, please leave them blank on the survey.]
3-year SRTR measure / Table C16 valuea.Number of transplants evaluated / ______
b.Estimated probability of surviving at 3 years (unadjusted) / ______%
c.Expected probability of surviving at 3 years (adjusted) / ______%
d.Number of observed deaths during the first 3 years after transplant / ______
e.Number of expected deaths during the first 3 years after transplant / ______
f.Estimated hazard ratio / ______
g.95% credible interval (low value) / ______
h.95% credible interval (high value) / ______
D22.1Please list the name your hospital reports under to SRTR. Also, please note that we will verify[30] the values reportedwith the SRTR/UNOS reports for your hospital. If the SRTR/UNOS values differ from the values reported here, please provide an explanation:
D23.Does your hospital track seasonal influenza vaccination of post-liver transplant patients seen by your Pediatric Gastroenterology program?
Yes – Go to Question D24
No – Skip to D25
D24.Of the total vaccine eligible[31]post-liver-transplant pediatric patients seen by your Pediatric Gastroenterology programbetween October 1, 2017 and December 31, 2017, what percentage received seasonal influenza vaccine (at your hospital or elsewhere) during that time periodor earlier that season?
______%
VALIDATE: 0 ≤ D24 ≤ 100. ELSE DISPLAY: “D24: Please enter a numeric value between 0 and 100.”
If D23=YES and D24=BLANK, DISPLAY: “D24: Please provide a value or answer No to D23.”
D25.Is your Pediatric Gastroenterology program currently engaged in any of the following activities?
Yes / Noa. / Developed and implemented a written plan for program review and quality improvement / ○ / ○
b. / Determined appropriate data-based performance metrics for the program / ○ / ○
c. / Regularly tracked patient data (e.g., diagnoses, treatment plans, test results, emergency department visits, outpatient visits, current treatment regimens) and other supporting information to measure progress against program performance metrics / ○ / ○
d. / Presented results of your program’s clinical quality performance metrics to your clinical staff on a regular basis / ○ / ○
e. / Participated in one or more quality improvement initiatives specific to pediatric gastroenterology care / ○ / ○
D25.1. If “yes” to any part of D25, please describe one quality improvement initiative and how it improved the quality of your program in the last calendar year. To receive credit, you must discuss what actions your hospital took as a result of this quality initiative and the impact it had on your program:
D26.Does your Pediatric Gastroenterology program have regular, multidisciplinary morbidity and mortality conferences[32] for pediatric GI patients at your institution?
Yes
No
D27.Does your Pediatric Gastroenterology program have a standard mechanism to contact all patients after they have undergone an outpatient GI procedure (e.g., endoscopy, liver biopsy, polypectomy, etc.) to determine if any complications have occurred?
Yes
No
D28.How many IRB approved protocols does your Pediatric GI program have that provide patients access to drugs, biologics (IND),or devices (IDE) not commercially available for general use through an expanded access program or limited use program, often known as compassionate use?[If none, please enter 0.]
______IRB Protocols
VALIDATE: IF D28 IS NOT A WHOLE NUMBER, DISPLAY: “D28: Please enter a whole number (no decimals).”
The next few questions ask about outcomes of care for your Pediatric GI program.
Please note that the question numbering has been updated for D29-D31.
D29.How many endoscopic procedures did your Pediatric GI program complete with pediatric patients in the last calendar year? How many severe complications (i.e., those that resulted in prolonged hospitalization, transfusion, transfer of care to a higher level such as an ICU, or death) occurred as a result of these endoscopic procedures in the last calendar year? [If multiple complications occurred with the same procedure, please count as a 1 complication.][If none, please enter 0.]
______Number of endoscopic procedures
______Number of serious complications following endoscopic procedures
VALIDATE: IF D29x IS NOT A WHOLE NUMBER, DISPLAY: “D29x: Please enter a whole number (no decimals).”
IF D29b > D29a, DISPLAY: “D29: Number of complications cannot be greater than number of procedures. If multiple complications occurred with the same procedure, please count as a 1 complication.”
IF D29x IS BLANK, DISPLAY: “D29x: If none, please enter 0.”
D30.How many unique biliary atresia patients received a Kasai procedure (see code list – must have both diagnosis and procedure code) from your Pediatric GI program in 2014-2016? [If none, please enter 0.]