{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T13:31:43Z","timestamp":1774359103150,"version":"3.50.1"},"reference-count":17,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T00:00:00Z","timestamp":1759449600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute appendicitis is the most common paediatric emergency presentation requiring timely surgical intervention. The Sydney Children's Hospital Network (SCHN) noted in their National Surgical Quality Improvement Program\u2010Pediatrics (NSQIP\u2010P) data that their appendicectomy postoperative length of stay (LOS) was longer than that of other hospitals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>\n                      NSQIP\u2010P reports are calculated from case reviews with a 30\u2010day post\u2010operative follow\u2010up. From 2020 to 2022, the post\u2010operative LOS for uncomplicated appendicectomy at SCHN was a median of 24\u2009h (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009714). A quality improvement project was initiated using Clinical Redesign Methodology. The project team developed an Uncomplicated Appendicectomy Guideline to standardize care. The Guideline also included a criteria\u2010led discharge that could be applied after 6\u2009h of post\u2010operative recovery. Comprehensive information was provided for parents\/carers on discharge.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In 2024, the median postoperative LOS was reduced from 24 to 16\u2009h (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009185). This represents a statistically significant reduction in post\u2010operative length of stay of 33%\n                      <jats:italic>(p\u2009&lt;\u20090.001).<\/jats:italic>\n                      There were no statistically significant increase in post\u2010operative readmissions\n                      <jats:italic>(p\u2009=\u20090.95)<\/jats:italic>\n                      or in NSQIP\u2010P morbidity rates, although there was an increase in post\u2010operative Emergency Department presentations noted, from a median of 7\u201310 annual presentations (\n                      <jats:italic>p\u2009&lt;\u20090.05, n<\/jats:italic>\n                      \u2009=\u2009444). There was positive feedback from parents\/carers with the earlier discharge (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200916). Parents\/carers who received the discharge information sheet reported that they were better informed about their child's care. Staff in focus groups highlighted a greater autonomy in post\u2010operative care (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200924).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Paediatric patients with uncomplicated appendicitis can be safely discharged from 6\u2009h post\u2010operatively with comprehensive discharge information.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70334","type":"journal-article","created":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T08:54:49Z","timestamp":1759481689000},"page":"2543-2549","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Same\u2010Day Discharge for Paediatric Uncomplicated Appendicitis in Australia"],"prefix":"10.1111","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5688-988X","authenticated-orcid":false,"given":"Kyla A.","family":"Clasie","sequence":"first","affiliation":[{"name":"Division of Surgery The Sydney Children's Hospital Network  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie G.","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Surgery The Sydney Children's Hospital at Randwick  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5629-8414","authenticated-orcid":false,"given":"Susan","family":"Adams","sequence":"additional","affiliation":[{"name":"Department of Surgery The Sydney Children's Hospital at Randwick  Sydney New South Wales Australia"},{"name":"University of New South Wales  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Karpelowsky","sequence":"additional","affiliation":[{"name":"Department of Surgery The Children's Hospital at Westmead  Sydney New South Wales Australia"},{"name":"University of Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rawaan","family":"James","sequence":"additional","affiliation":[{"name":"The Children's Hospital at Westmead Surgical Ward  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica L.","family":"Iemma","sequence":"additional","affiliation":[{"name":"Department of Surgery The Sydney Children's Hospital at Randwick  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy C.","family":"Cowie","sequence":"additional","affiliation":[{"name":"The Children's Hospital at Westmead Surgical Ward  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Hann","sequence":"additional","affiliation":[{"name":"Emergency Department The Children's Hospital at Westmead  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keeley","family":"Hickey","sequence":"additional","affiliation":[{"name":"The Sydney Children's Hospital at Randwick Short Stay Surgical Ward C1SW  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Casey J.","family":"Haubus","sequence":"additional","affiliation":[{"name":"The Sydney Children's Hospital at Randwick Short Stay Surgical Ward C1SW  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura A.","family":"Constable","sequence":"additional","affiliation":[{"name":"The Sydney Children's Hospital at Randwick Short Stay Surgical Ward C1SW  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donald","family":"Hannah","sequence":"additional","affiliation":[{"name":"Division of Surgery The Sydney Children's Hospital Network  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6595-654X","authenticated-orcid":false,"given":"Blessy","family":"John\u2010Denny","sequence":"additional","affiliation":[{"name":"University of Sydney  Sydney New South Wales Australia"},{"name":"Emergency Department The Children's Hospital at Westmead  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katie R.","family":"Prettyman","sequence":"additional","affiliation":[{"name":"Emergency Department The Children's Hospital at Westmead  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Donaldson","sequence":"additional","affiliation":[{"name":"Emergency Department The Children's Hospital at Westmead  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Butler","sequence":"additional","affiliation":[{"name":"Sydney Children's Network Electronic Medical Records Unit  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ariella","family":"Xerri","sequence":"additional","affiliation":[{"name":"The Children's Hospital at Westmead Operating Suite  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamilie","family":"Antoun","sequence":"additional","affiliation":[{"name":"The Children's Hospital at Westmead Operating Suite  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2911-6520","authenticated-orcid":false,"given":"Grahame H. H.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Urology The Children's Hospital at Westmead  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3745-8704","authenticated-orcid":false,"given":"Andrew J. A.","family":"Holland","sequence":"additional","affiliation":[{"name":"Department of Surgery The Children's Hospital at Westmead  Sydney New South Wales Australia"},{"name":"University of Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,3]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-024-10813-y"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2020.08.056"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2014.03.030"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2014.03.012"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2018.03.072"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.15125"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2018.05.027"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-021-04880-8"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2020.05.067"},{"key":"e_1_2_10_11_1","unstructured":"\u201cAmerican College of Surgeons. National Surgical Quality Improvement Program Pediatric (NSQIP\u2010P) \u201d2020\u20102024 Semi\u2010Annual report. Chicago USA."},{"key":"e_1_2_10_12_1","unstructured":"New South Wales Health Agency of Clinical Innovation \u201cClinical Redesign Methodology. Sydney Australia \u201d2021."},{"key":"e_1_2_10_13_1","unstructured":"Sydney Children's Hospital \u201cUncomplicated Appendicectomy Practice Guideline \u201d2024."},{"key":"e_1_2_10_14_1","unstructured":"Sydney Children's Hospital Network \u201cUncomplicated Appendicectomy Discharge \u201d(2024) https:\/\/www.prod.schn.health.nsw.gov.au\/uncomplicated\u2010appendicectomy\u2010discharge\u2010information\u2010sheet."},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2022.944405"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-021-03872-3"},{"issue":"5","key":"e_1_2_10_17_1","first-page":"318","article-title":"Parental Satisfaction With Same\u2010Day Discharge After Laparoscopic Appendectomy for Uncomplicated Appendicitis","volume":"24","author":"Ngo S.","year":"2018","journal-title":"Paediatrics and Child Health"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.17061\/phrp3042030"}],"container-title":["ANZ Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.70334","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T07:53:46Z","timestamp":1766217226000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ans.70334"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,3]]},"references-count":17,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1111\/ans.70334"],"URL":"https:\/\/doi.org\/10.1111\/ans.70334","archive":["Portico"],"relation":{},"ISSN":["1445-1433","1445-2197"],"issn-type":[{"value":"1445-1433","type":"print"},{"value":"1445-2197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,3]]},"assertion":[{"value":"2025-08-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}