• Danielle B Cameron and Shawn J Rangel.
• Department of Surgery, Children׳s Hospital Boston, Harvard Medical School, 300 Longwood Ave, Fegan-3, Boston, Massachusetts 02115.
• Semin. Pediatr. Surg. 2015 Dec 1; 24 (6): 291-4.

AbstractVariation in care and outcomes are common in the management of children with surgical diseases. Differences in the availability of resources, patient and family preferences, ever-increasing fiscal pressure, and lack of high-quality data to guide clinical decision making are just a few factors that contribute to both the over and under-utilization of healthcare resources. Identification of data-driven, value-based "best practices" that are sensitive to differences in resource availability and patient preferences may be an important first step in establishing a practical framework for reducing unwarranted practice variation. The goal of this article is to explore the causes and influence of practice variation using appendicitis as a common condition to illustrate key concepts, and to propose solutions to mitigate unwarranted practice variation while preserving the spirit of innovation necessary to advance the field.Copyright © 2015 Elsevier Inc. All rights reserved.

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