Consensus on ambulatory care among Quebec otolaryngologists

Area of Science:

• Otolaryngology
• Surgical Procedures
• Healthcare Management

Background:

• Outpatient surgical facilities are increasingly utilized for various procedures.
• Determining the suitability of specific surgeries for outpatient settings requires expert consensus.
• The Delphi method offers a structured approach to achieve consensus among healthcare professionals.

Purpose of the Study:

• To achieve consensus on the suitability of outpatient facilities for 15 ear, nose, and throat (ENT) surgical procedures.
• To identify key factors influencing decisions regarding the suitability of ENT surgeries for outpatient settings.
• To evaluate the efficacy of the Delphi method in establishing consensus for surgical procedure suitability.

Main Methods:

• A prospective study involving 26 otolaryngologists in Quebec.
• Utilized a three-round Delphi method to gather expert opinions.
• Assessed 15 adult and 9 pediatric surgical procedures for outpatient suitability.

Main Results:

• Consensus (85% agreement) was achieved for eight procedures.
• Suitable outpatient procedures include septoplasty, rhinoplasty, endoscopic sinus surgery, otoplasty, mastotympanoplasty, lymph node biopsy, and branchial cyst excision.
• Tracheostomy was identified as an inpatient procedure requiring consensus.

Conclusions:

• The Delphi method proved effective in initiating the rationalization of outpatient surgery.
• Expert consensus can guide the appropriate selection of procedures for outpatient settings.
• This study provides a foundation for evidence-based decision-making in ENT outpatient surgery.