Related Experiment Video
Updated: May 31, 2025
CO2-Lasertonsillotomy Under Local Anesthesia in Adults
Published on: November 6, 2019
Developing a novel tonsillitis pathway to reduce pressures on front-door services: A multi-phase quality improvement
Lucy M S Hoade1, Elliott N Rees2
1Department of Ear, Nose and Throat Surgery, University Hospital Wales, Cardiff, Wales CF14 4XW, UK.
Background:
Tonsillitis places a significant strain on healthcare services, with rising admission rates over recent years. There is an urgent need for strategies to alleviate unprecedented demand on secondary care via safe alternatives to hospital admission. This quality improvement project demonstrates development of an early discharge pathway in combination with an ENT-led Surgical Same Day Emergency Care (SDEC) unit.
Methods:
All cases of acute tonsillitis (n = 127) and peritonsillar abscess (n = 43) were reviewed across two intervention phases (Aug-Oct 2021 and June-Oct 2022), which each involved a retrospective baseline audit, followed by post-intervention prospective audit cycles to assess hospital length of stay (LOS) and readmission rates.
Results:
Introduction of a tonsillitis management protocol resulted in a reduction in mean LOS from 22 to 12 h (p = 0.004). Mean LOS reverted to 20 h in the second baseline audit. Further audit cycles demonstrated a sustained reduction in mean LOS to 13 h (p = 0.017) with use of the SDEC. Readmission rates remained low through all audit cycles.
Conclusion:
Patients with acute tonsillitis can be safely managed via an early discharge pathway. Use of SDEC to deliver this protocol reduces pressure on front-door services, reduces LOS and does not affect readmission rate.
Related Concept Videos
01:23Chronic Pharyngitis
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
01:26Tonsillitis II: Management
01:30Tonsillitis I: Introduction
Etiology
Three primary contributing factors have been identified.
01:30Acute Pharyngitis
Acute pharyngitis is the inflammation of the back of the throat (pharynx), commonly resulting in a sore throat. It is a frequently encountered condition that prompts individuals to seek medical advice.
Classification
Acute pharyngitis can be categorized based on its underlying cause:
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...