Impact of an Order Set on Communication and Length of Stay After Pediatric Spinal Fusion.

Background This study aimed to evaluate the impact of a standardized postoperative order set on interdisciplinary communication and hospital length of stay (LOS) among pediatric patients undergoing posterior spinal fusion (PSF) for idiopathic scoliosis. Methodology LOS was compared among patients younger than 18 years using Epic SlicerDicer data from the pre-implementation period (2021 through January 17, 2024; n = 58) and the post-implementation period (January 18 through December 2024; n = 14). Pediatric residents were surveyed regarding the frequency of interdisciplinary communication before and after implementation. Statistical analyses used Fisher's exact test and an independent-samples t-test. Results Mean LOS decreased from 3.91 days pre-implementation to 3.71 days post-implementation, though not statistically significant (p = 0.60). Survey responses demonstrated significant reductions in paging frequency for pain management (p = 0.043), drain output (p = 0.004), and pediatric-to-orthopedic communication regarding blood pressure concerns (p = 0.010). Overall interdisciplinary communication between pediatrics, orthopedics, and nursing improved. Conclusions Implementation of a standardized postoperative order set for pediatric patients undergoing PSF for idiopathic scoliosis significantly reduced unnecessary paging related to pain management, blood pressure monitoring, and drain output, while enhancing interdisciplinary communication. A trend toward shorter LOS was observed. These findings align with prior evidence that structured, diagnosis-specific order sets improve care coordination, efficiency, and patient outcomes in pediatric inpatient settings.