Introducing paediatric grommet "rapid turnover" lists. A Quality Improvement Project

Area of Science:

• Otolaryngology
• Pediatric Surgery
• Healthcare Management

Background:

• Paediatric grommet insertion is a common daycase ENT procedure.
• National Institute for Health and Care Excellence (NICE) guidelines (CG60) define criteria for grommet insertion.
• Long waiting times (78% breaching 18-week RTT target) and high day-of-surgery cancellations (8%) were observed due to outdated audiograms and unmet criteria.

Purpose of the Study:

• To decrease waiting times for paediatric grommet insertions.
• To reduce on-the-day cancellations for paediatric grommet surgery.
• To improve efficiency in paediatric daycase ENT theatre lists.

Main Methods:

• Introduction of a pilot scheme with "rapid turnover" paediatric day case theatre lists.
• Implementation of a pre-operative consent clinic to identify non-surgical candidates.
• Utilisation of senior ENT registrars and dual anaesthetic teams ('pods') for faster patient throughput.

Main Results:

• Elimination of all patients breaching the 18-week RTT target on the grommet waiting list.
• Zero on-the-day cancellations due to surgery not being indicated.
• High satisfaction reported by staff and patients involved in the pilot scheme.

Conclusions:

• The "rapid turnover" model is effective in reducing paediatric grommet surgery waiting lists and cancellations.
• The model ensures patients meet NICE criteria at the time of surgery.
• The successful pilot scheme is planned for regular implementation to maintain reduced waiting times.