583 - Utilization of Epic SlicerDicer to Evaluate Pediatric Quality of Care in the Community Hospital Emergency Departments

Publication Number: 1560.583

Jessica K. Creedon, Boston Children's Hospital, Dover, MA, United States; Caitlin Kent, Boston Children's Hospital, Norfolk, MA, United States; John J. Porter, Boston Children's Hospital, Boston, MA, United States; Megan Trexler, Boston Children's Hospital, Walpole, MA, United States; Niloufar Paydar-Darian, Boston Children's Hospital, Boston, MA, United States; Melissa Sundberg, Boston Children's Hospital, Boston, MA, United States

Background: Pediatric emergency care is primarily delivered in community hospital settings rather than academic medical centers. Despite efforts to benchmark pediatric emergency quality, community hospitals often lack the informatics infrastructure and analytic resources needed to evaluate processes or identify opportunities for improvement. Health information technology (IT) platforms, such as Epic SlicerDicer (SD), offer self-service accessible tools for clinicians to generate data-driven insights without dedicated data analysts. However, the validity and utility of these tools for quality assessment in pediatric emergency medicine remains underexplored.

Objective: 1. To determine the reliability of SD-generated Choosing Wisely metrics and mitigate IT access challenges that limit data use in community EDs.
2. To compare rates of diagnostic imaging between an urban freestanding tertiary pediatric emergency department (ED) and an affiliated community pediatric ED.

Design/Methods: To determine accuracy, we compared data extracted from SD at both hospital locations to data extracted from reports developed by a dedicated data team at a pediatric academic center. A retrospective analysis of ED encounters for four Choosing Wisely Campaign imaging measures was conducted. These included chest X-ray for bronchiolitis, chest or soft tissue neck X-ray for croup, abdominal X-ray for constipation, and head CT or MRI for afebrile seizure without focal findings. Encounters from July 2024 to July 2025 were identified using ICD-10-CM diagnosis and procedure codes. Monthly rates were analyzed via statistical process control (SPC) charts and compared between locations.

Results: SD-derived data showed high concordance with analyst-generated reports, supporting its validity for local measurement. Clinicians at both institutions independently built and refined queries, demonstrating feasibility without dedicated analytic support. Among 7,490 ED encounters (academic: 5,125; community: 2,365), baseline imaging rates were similar between sites-bronchiolitis (20% vs 23%), croup (20% vs 6%), constipation (60% vs 63%), and seizure (12% vs 12%). SPC analyses will assess ongoing longitudinal trends.

Conclusion(s): Preliminary findings demonstrate comparable rates of imaging between affiliated academic and community pediatric EDs. The use of SD enabled timely, community-level data generation, overcoming traditional barriers to quality measurement in non-academic settings. These findings highlight the potential for clinician-driven informatics tools to support quality improvement and promote data equity across diverse healthcare environments.

Chest X-Ray Imaging Rate for Bronchiolitis at an Academic Pediatric Emergency Department
SPC p-chart showing monthly Chest X-Ray Imaging Rate for Bronchiolitis at an Academic Pediatric Emergency Department extracted from Epic Slicer Dicer data.

Chest X-Ray Imaging Rate for Bronchiolitis at a Community Pediatric Emergency Department
SPC p-chart showing monthly Chest X-Ray Imaging Rate for Bronchiolitis at a Community Pediatric Emergency Department extracted from Epic Slicer Dicer data.