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Same-Day Evaluation and Surgery for Otitis Media and Tympanostomy Tube Placement: A Feasibility Study
Kathleen R Billings1, John Hajduk2, Allison Rose3
1Division of Pediatric Otolaryngology-Head and Neck Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, and Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA kbillings@luriechildrens.org.
Insights
Streamlined same-day surgery for children needing tympanostomy tubes (TT) significantly reduces clinic wait times and overall care duration. This efficient process improves the experience for managing recurrent otitis media.
Area of Science:
- Pediatric Otolaryngology
- Health Services Research
Background:
- Recurrent otitis media and chronic otitis media with effusion are common pediatric conditions requiring tympanostomy tube (TT) placement.
- Traditional care pathways involve multiple visits, potentially leading to delays and decreased efficiency.
Purpose of the Study:
- To evaluate the feasibility and efficiency of a streamlined, same-day evaluation and surgical management process for children requiring tympanostomy tubes.
- To compare facility and surgical times between same-day and traditional (non-same-day) TT placement procedures.
Main Methods:
- A retrospective matched case series design was employed at a tertiary care children's hospital.
- Thirty children undergoing same-day TT placement were matched to a comparison group receiving routine, non-same-day TT placement based on age, sex, and insurance.
- Parent satisfaction surveys were administered to assess the patient experience.
Main Results:
- Same-day TT placement significantly reduced preoperative clinic visit time (15 minutes vs. 51.5 minutes; P < .001).
- Overall care episode duration was significantly shorter for same-day patients (151 minutes vs. 196 minutes; P < .001).
- Operative times were comparable between groups (145 minutes vs. 137 minutes; P = .35), and all parents in the same-day group reported satisfaction with the efficiency.
Conclusions:
- A same-day surgery model is feasible and improves the efficiency of care for children requiring tympanostomy tubes for otitis media.
- This streamlined approach offers a valuable alternative for managing pediatric otitis media, enhancing patient and family experience.
Objective:
To determine the feasibility of providing streamlined same-day evaluation and surgical management of children with recurrent otitis media or chronic serous otitis media who meet criteria for tympanostomy tube (TT) placement.
Study Design:
Retrospective matched case series.
Setting:
Tertiary care children's hospital.
Methods:
A comparison group (age, sex, insurance product) was utilized to determine if the same-day process decreased facility time and surgical time for the care episode. A parent satisfaction survey was administered.
Results:
Thirty children, with a median age of 16 months (range, 12-22 months), participated in the same-day surgery process for TT. Twenty-one patients (70.0%) were male, and these patients were matched to a comparison group (similar age, sex, and insurance product) having non-same-day (routine) TT placement. The same-day patients spent significantly less time in clinic for the preoperative physician visit (average, 15 minutes) when compared with the non-same-day patients (average, 51.5 minutes; P < .001). The operative experience for the same-day patients was similar to the non-same-day patients (average, 145 vs 137 minutes, respectively; P = .35), but the overall experience was significantly shorter for the same-day patients (average, 151 vs 196 minutes for comparisons; P < .001). All parents surveyed in the same-day group were satisfied with the efficiency of the experience.
Conclusion:
The same-day surgery process for management of children who meet the criteria for TT placement is a model of improved efficiency of care for children who suffer from otitis media.
