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How Do Academic Otolaryngologists Decide to Implement New Procedures Into Practice?

Bethany Powers¹, Cara Damico Smith¹, Natalia Arroyo¹

¹Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery

|September 21, 2021

Summary

Adoption of new surgical procedures in otolaryngology is driven by improved patient outcomes. Barriers include cost and learning curves, while trust and clear benefits facilitate implementation.

Keywords:

implementation science innovation otolaryngology practice change surgery

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Area of Science:

Implementation science
Surgical innovation
Otolaryngology

Background:

New surgical procedures require understanding adoption barriers and facilitators.
An implementation science framework can characterize socioemotional, clinical, and decision-making processes.

Purpose of the Study:

To identify barriers and facilitators to the adoption of new surgical procedures in otolaryngology.
To characterize the socioemotional, clinical, and decision-making processes involved in surgical innovation.

Main Methods:

Qualitative study using semistructured interviews with academic otolaryngologists.
Thematic coding of interview transcripts to identify facilitators and barriers.
Analysis within the context of a clinical pathway.

Main Results:

Facilitators for adoption included improving patient outcomes, addressing unmet needs, establishing trust, and workflow efficiency.
Barriers included costs, profit-driven technology adoption without improved outcomes, communication hesitancy, and steep learning curves.
Sustaining implementation depended on favorable outcomes and patient satisfaction, while insufficient referrals hindered it.

Conclusions:

Surgical innovation in otolaryngology is often an individual pursuit for improved patient outcomes.
Generating sufficient evidence for surgical innovation faces challenges in specialty practice due to limited provider and patient numbers.