Pediatric Surgery – EPSA
European Pediatric Surgical Audit (EPSA)
In the Netherlands, approximately 3 in 100 babies are born with a congenital anomaly. Some of these children require surgery, with cases ranging from mild to severe. The exact cause of these conditions is often unknown.
DICA Pediatric Surgery Quality Registry
Through the DICA Pediatric Surgery Quality Registry (EPSA), we collect data on (newborn) children with congenital, rare, anatomical anomalies. We analyze patient characteristics, treatments, and outcomes and present these insights in our dashboards. Healthcare professionals use this information to assess and compare the quality and effectiveness of care. This enables them to improve care for patients with congenital anomalies.
The conditions registered in EPSA fall under specialized pediatric surgery. A relatively small group of surgeons, from six university medical centers in the Netherlands, focus on this field. They work closely together, following largely the same guidelines and surgical procedures. Due to the relatively small number of cases, identifying differences between centers can be challenging. Expanding the patient group is essential for optimizing treatments and identifying outliers. Given the low patient numbers, extending this quality registry across Europe is necessary. Currently, pediatric surgeons from 15 countries collaborate within the European Reference Network ERNICA, with ongoing expansion.
EPSA was established in 2014 on the initiative of the Dutch Association of Pediatric Surgery (NVKC).
Pediatric Surgery – EPSA
European Pediatric Surgical Audit (EPSA)
In the Netherlands, approximately 3 in 100 babies are born with a congenital anomaly. Some of these children require surgery, with cases ranging from mild to severe. The exact cause of these conditions is often unknown.
DICA Pediatric Surgery Quality Registry
Through the DICA Pediatric Surgery Quality Registry (EPSA), we collect data on (newborn) children with congenital, rare, anatomical anomalies. We analyze patient characteristics, treatments, and outcomes and present these insights in our dashboards. Healthcare professionals use this information to assess and compare the quality and effectiveness of care. This enables them to improve care for patients with congenital anomalies.
The conditions registered in EPSA fall under specialized pediatric surgery. A relatively small group of surgeons, from six university medical centers in the Netherlands, focus on this field. They work closely together, following largely the same guidelines and surgical procedures. Due to the relatively small number of cases, identifying differences between centers can be challenging. Expanding the patient group is essential for optimizing treatments and identifying outliers. Given the low patient numbers, extending this quality registry across Europe is necessary. Currently, pediatric surgeons from 15 countries collaborate within the European Reference Network ERNICA, with ongoing expansion.
EPSA was established in 2014 on the initiative of the Dutch Association of Pediatric Surgery (NVKC).
Results
- EPSA expanded from 5 to 17 countries and from 11 to 33 hospitals.
- There are currently 6 ongoing international, multidisciplinary projects.
- Since 2022, annual peer-review sessions have been organized to drive quality improvement and enhance international collaboration.
- A successful data verification project was conducted in Dutch centers from 2018 to 2021 to improve data quality and facilitate quality improvement initiatives.
Patient Group
This registry collects data on all patients undergoing surgery for:
- Esophageal atresia (oesophageal atresia)
- Hirschsprung’s disease
- Congenital diaphragmatic hernia
- Abdominal wall defects (gastroschisis and omphalocele)
- Anorectal malformations (anomalies of the anus and rectum)
- Intestinal malrotation
- Necrotizing enterocolitis
Patient Perspective
Improving patient care requires patient input. Therefore, patient representatives are involved in all international projects and in selecting quality indicators.
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Learning and Improving
EPSA participants receive weekly updates on their own performance through our Codman dashboard, which benchmarks their results against the European average. This real-time feedback supports continuous learning and improvement.
In 2022, the first peer-review session took place in Helsinki, focusing on Hirschsprung’s disease and congenital diaphragmatic hernia. In 2023, the discussion in Madrid centred on oesophageal atresia, with a particular emphasis on anastomotic leakage. In 2024, the spotlight shifted to omphalocele during the session in Wroclaw. This year, Hirschsprung’s disease will once again be the main focus at the peer-review session in Frankfurt.
Clinical Audit Board EPSA
- Co-Chairman: Prof. Dr. L.W.E. van Heurn, Pediatric Surgeon, Maastricht UMC+, Maastricht
- Co-Chairman: Prof. Dr. R.M.H. Wijnen, Pediatric Surgeon, Erasmus MC, Rotterdam
- Prof. Dr. J.B.F. Hulscher, Pediatric Surgeon, UMCG, Groningen
- Prof. Dr. M.P. Pakarinen, Pediatric Surgeon, HUS Children’s Hospital, Helsinki (Finland)
- Prof. Dr. S. Eaton, Pediatric Surgeon, GOSH, London (United Kingdom)