A Scoping Review on Learning Health Networks Available in Pediatric Surgical Specialties

Michael E Chua; Jan Michael Silangcruz; Jin Kyu Kim; Martin A Koyle; Abi Sriharan

doi:10.1016/j.jpedsurg.2023.07.006

A Scoping Review on Learning Health Networks Available in Pediatric Surgical Specialties

J Pediatr Surg. 2023 Dec;58(12):2416-2428. doi: 10.1016/j.jpedsurg.2023.07.006. Epub 2023 Jul 13.

Authors

Michael E Chua¹, Jan Michael Silangcruz², Jin Kyu Kim³, Martin A Koyle⁴, Abi Sriharan⁴

Affiliations

¹ Global Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada; Division of Urology, Department of Surgery, The Hospital for Sick Children, Toronto, ON, Canada; Institute of Urology, St. Luke's Medical Center, Quezon City, NCR, Philippines. Electronic address: michael.chua@sickkids.ca.
² Institute of Urology, St. Luke's Medical Center, Quezon City, NCR, Philippines.
³ Department of Surgery, Faculty of Medicine and Surgery, University of Toronto, ON, Canada.
⁴ System Leadership and Innovation, Institute of Health Policy, Management and Evaluation, University of Toronto, ON, Canada.

PMID: 37544802
DOI: 10.1016/j.jpedsurg.2023.07.006

Abstract

Background: Learning health networks (LHN) are consortia of institutions that collaborate and embrace the elements of the learning health system (LHS), including quality improvement, education, research, and stakeholder involvement. Their ultimate goal is rapid information dissemination in clinical care. Pediatric surgical specialties perform unique yet high-impact procedures that could benefit from LHN, thereby improving surgical outcomes and care through LHS approaches. Consequently, health system leaders should be aware of LHN and their importance in enhancing surgical care and improving outcomes. This scoping review aims to map and characterize the existing LHN applied in pediatric surgical specialties.

Methods: A systematic literature search was performed on Medline, EMBASE, and Scopus up to June 2022, with an update search conducted in May 2023. Additionally, Google Scholar, ProQuest and inquiry from topic experts were used for cross-referencing relevant review articles to identify grey literature. This scoping review was conducted and reported according to the PRISMA-scoping review extension.

Results: A total of 56 publications for 19 LHN were identified and included in this scoping review. Out of 19 identified LHN in pediatric surgical specialties, 18 were organized in North America. Eight of the networks are related to pediatric general surgery and another eight were related to pediatric transplantation. The 16 out of 19 LHN were initiated after 2001. To date, only eight of the LHNs generated reports of comparative improved outcomes.

Conclusion: This scoping review provides an overview of the available LHNs in pediatric surgical specialties. Over the past decade, several pediatric surgical specialties have embraced the principles of learning health systems, forming inter-institutional collaborations that utilize information technology to generate big data on patient-level clinical information, engage in quality improvement cycles, adopt evidence-based practices, and actively involve patients and stakeholders.

Level of evidence: IV.

Keywords: Learning health network; Learning health system; Pediatric surgical specialties; Scoping review.

Publication types

Systematic Review
Review

MeSH terms

Altruism
Awareness
Child
Educational Status
Humans
Learning Health System*
North America