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Implementation of an acute tonsillitis management protocol within a clinical decisions unit
Annals of the Royal College of Surgeons of England
|August 26, 2021
Summary
Implementing an acute tonsillitis management protocol in a clinical decisions unit (CDU) improved treatment delivery and reduced hospital admissions. This standardized approach proved safe and effective for acute tonsillitis care.
Area of Science:
- Emergency Medicine
- Clinical Protocol Implementation
- Acute Tonsillitis Management
Background:
- Rising admissions for acute tonsillitis in the UK due to stricter tonsillectomy commissioning criteria.
- Previous studies indicate standardized protocols improve acute tonsillitis treatment in emergency departments.
Purpose of the Study:
- To implement and evaluate an acute tonsillitis management protocol within a clinical decisions unit (CDU) pathway.
- To assess the safety and efficacy of the protocol through data collection.
Main Methods:
- A novel approach using a clinical decisions unit (CDU) pathway for acute tonsillitis management.
- Retrospective baseline audit followed by two post-intervention data collection cycles.
Main Results:
- Significant increase in median initial treatments from 2/5 at baseline to 3/5 post-intervention.
- Reduced admission rate from 0.79 to 0.44 (44.6% reduction) in the first cycle (p=0.0547).
- Sustained reduction in admission rate to 0.48 (39.2% reduction) in the second cycle (p=0.038).
Conclusions:
- Clinical decisions unit (CDU) utilization improved initial treatment delivery and extended observation periods.
- A greater percentage of patients were discharged following protocol implementation.
- The acute tonsillitis management protocol within a CDU is a safe, effective, and now standard model of care.
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