Implementation and impact of a surgical dashboard on pediatric tonsillectomy outcomes: A quality improvement study
Introduction In pediatric tonsillectomy management, the consistent tracking of surgical outcomes and adherence to guidelines are vital. This study explores how a surgical dashboard can serve as a tool in research analysis, translating AAO‐HNSF guidelines into measurable performance improvements. Met...
Saved in:
| Published in: | Laryngoscope investigative otolaryngology Vol. 9; no. 5; pp. e1315 - n/a |
|---|---|
| Main Authors: | , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Hoboken, USA
John Wiley & Sons, Inc
01-10-2024
Wiley |
| Subjects: | |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | Introduction
In pediatric tonsillectomy management, the consistent tracking of surgical outcomes and adherence to guidelines are vital. This study explores how a surgical dashboard can serve as a tool in research analysis, translating AAO‐HNSF guidelines into measurable performance improvements.
Methods
Using a prospective registry from three pediatric hospitals, a Tableau dashboard was constructed to graphically visualize key demographic and postoperative outcomes (including intensive care unit [ICU] utilization, 30‐day emergency department (ED) visits, and postoperative bleed rates) in children undergoing tonsillectomy from 2020 to 2024. From the dashboard data, a retrospective cohort study analyzing 6767 tonsillectomies was conducted from January 2, 2020, to June 20, 2023. Patients were categorized into low‐risk, OSA‐only (by ICD‐10 codes), and high‐risk groups based on comorbidities. Logistic regression identified factors influencing ED revisits and unplanned nursing calls. Three quality initiatives were assessed: preoperative school absence notes, perioperative dexamethasone recording, and post‐tonsillectomy parental education.
Results
A total of 2122 (31%) were low‐risk, 2648 (39%) were OSA‐only, and 1997 (30%) high risk. Risk factors that increased the likelihood of ED visits were high‐risk comorbidities (OR = 1.46; 95% CI = 1.24–1.74; p < 0.001) and older age (OR = 1.05; 95% CI = 1.03–1.08; p < 0.001). Risk factors that increased the likelihood of an unplanned nursing communication were high‐risk comorbidities (OR = 1.53; 95% CI = 1.34–1.75; p < 0.001), older age (OR = 1.03, 95% CI = 1.01–1.04; p = 0.001), and Medicaid insurance (OR = 1.25; 95% CI = 1.09–1.43; p = 0.002). Postoperative bleed control was generally comparable between the groups, at 2.8% (low risk), 2.7% (OSA), 3.2 (high risk) (p = 0.651).
Conclusion
The dashboard aided in data collection, data visualization, and data analysis of quality improvement initiatives, effectively translating guidelines into tangible measures to enhance care.
Level of evidence
NA.
This dynamic tonsillectomy dashboard was fundamental to monitoring outcomes of quality improvement initiatives, collecting and analyzing data for a retrospective cohort study, and identifying areas for improvement within a pediatric otolaryngology department. |
|---|---|
| Bibliography: | Meeting information: This abstract was presented at 126th Annual Meeting of the Triological Society in Chicago, IL on May 17, 2024. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| ISSN: | 2378-8038 2378-8038 |
| DOI: | 10.1002/lio2.1315 |