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Completion of postoperative polysomnography for children with severe obstructive sleep apnea: A quality improvement

Wen Jiang1,2, Rakesh Bhattacharjee2,3, Javan Nation1,2

  • 1Department of Otolaryngology University of California San Diego San Diego California USA.

Laryngoscope Investigative Otolaryngology
|October 19, 2022
PubMed

Insights

A quality improvement project increased postoperative polysomnography completion rates in pediatric patients with severe obstructive sleep apnea (OSA) after tonsillectomy. This initiative successfully identified residual OSA, improving patient care through enhanced monitoring.

Area of Science:

  • Pediatric Sleep Medicine
  • Quality Improvement Science
  • Surgical Outcomes Research

Background:

  • Pediatric patients with severe obstructive sleep apnea (OSA) face risks of residual OSA post-tonsillectomy with/without adenoidectomy (T±A).
  • Identifying residual OSA is crucial for effective management and preventing complications.

Purpose of the Study:

  • To implement a quality improvement (QI) project to increase the rate of postoperative polysomnography (PSG) completion in pediatric patients undergoing T±A for severe OSA.
  • To improve the identification of residual OSA in this vulnerable patient population.

Main Methods:

  • A prospective QI project was conducted at a tertiary pediatric academic hospital.
  • The project targeted children ≤18 years undergoing T±A for severe OSA.
  • A SMART aim was set to increase postop PSG completion from 70% to 95% by May 2021, utilizing patient education and electronic medical record functionalities.

Main Results:

  • Pre-intervention, postop PSG completion was 69.7% with an average time of 99 days between surgery and PSG.
  • Following intervention, the PSG completion rate improved to 94.9% by September 2021.
  • The average time between surgery and postop PSG significantly decreased to 57 days (p < .001).

Conclusions:

  • A multidisciplinary QI approach successfully achieved the aim of increasing postop PSG completion rates.
  • The established QI infrastructure supports sustainable delivery of improved patient care.
  • Enhanced PSG completion facilitates timely diagnosis and management of residual OSA in pediatric patients.
Abstract

Keywords:
pediatric obstructive sleep apneapolysomnographyquality improvement

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