Streamlining grommet pathways for otitis media with effusion and hearing loss in children: our experience
Insights
Streamlining grommet insertion for children with otitis media with effusion through direct-listing pathways significantly reduced surgical wait times. This pathway, guided by National Institute for Health and Care Excellence Clinical Guideline 60, expedites care.
Area of Science:
- Pediatric Otolaryngology
- Healthcare Management
Background:
- Grommet insertion is a common pediatric surgical procedure.
- Extended waiting times for grommet insertion are a significant clinical challenge.
- Current pathways often involve lengthy delays between audiology assessment and surgical scheduling.
Purpose of the Study:
- To evaluate the effectiveness of a direct-listing pathway for audiologists to schedule children for grommet insertion.
- To reduce waiting times for pediatric patients meeting specific clinical guidelines.
Main Methods:
- Retrospective audit of patient data from June to November 2014.
- Implementation of a direct-listing pathway for audiologists based on National Institute for Health and Care Excellence Clinical Guideline 60.
- Comparison of waiting times before and after pathway implementation.
Main Results:
- The mean duration between the first audiology appointment and grommet insertion decreased from 294.5 days to 232 days.
- A statistically significant reduction in waiting time was observed (mean difference of 62.5 days, p = 0.024).
- Waiting time between the second audiology appointment and surgery also reduced significantly (28 days, p = 0.009).
Conclusions:
- Direct-listing pathways are effective in reducing surgical waiting times for grommet insertion.
- This streamlined process requires a minor adjustment to existing practices and adherence to clinical guidelines.
- ENT specialists retain the final decision-making authority for surgical intervention.
Background:
Grommet insertion is a common surgical procedure in children. Long waiting times for grommet insertion are not unusual. This project aimed to streamline the process by introducing a pathway for audiologists to directly schedule children meeting National Institute for Health and Care Excellence Clinical Guideline 60 ('CG60') for grommet insertion.Method and resultsA period from June to November 2014 was retrospectively audited. Mean duration between the first audiology appointment and grommet insertion was 294.5 days (median = 310 days). Implementing the direct-listing pathway reduced the duration between first audiology appointment and grommet insertion (mean = 232 days; median = 231 days). There has been a reduction in the time between the first audiology appointment and surgery (mean difference of 62.5 days; p = 0.024), and a reduction in the time between second audiology appointment and surgery (28 days; p = 0.009).
Conclusion:
Direct-listing pathways for grommet insertion can reduce waiting times and expedite surgery. Implementation involves a simple alteration of current practice, adhering to National Institute for Health and Care Excellence Clinical Guideline 60. The ultimate decision regarding surgery still rests with ENT specialists.
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