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Improving Intraoperative Parathyroid Hormone Monitoring with a Multidisciplinary Checklist: A Quality Improvement

Austin R Swisher1, Justin M Hintze1, Chee-Chee H Stucky2

  • 1Department of Otolaryngology-Head & Neck Surgery, Mayo Clinic, Phoenix, Arizona, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|December 26, 2025
PubMed
Summary
This summary is machine-generated.

A new checklist significantly speeds up intraoperative parathyroid hormone (ioPTH) testing during parathyroid surgery. This improves surgical efficiency and reduces patient wait times for critical test results.

Keywords:
PS/QIchecklistintraoperative monitoringparathyroidparathyroid hormonequality improvementturnaround time

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Area of Science:

  • Endocrinology
  • Surgical Pathology
  • Quality Improvement in Healthcare

Background:

  • Intraoperative parathyroid hormone (ioPTH) monitoring is essential for confirming successful parathyroid surgery.
  • Delays in ioPTH assay processing can extend operative times, impacting surgical efficiency.
  • Standardized workflows are needed to optimize the ioPTH testing process.

Purpose of the Study:

  • To evaluate the effectiveness of a multidisciplinary checklist in expediting intraoperative parathyroid hormone (ioPTH) assay processes.
  • To assess the impact of the checklist on reducing ioPTH assay turnaround time and operative time.
  • To determine if the checklist improves workflow efficiency in parathyroid surgery.

Main Methods:

  • Development of a multidisciplinary checklist to standardize ioPTH collection and workflow.
  • Prospective study of 30 patients using the checklist (intervention group).
  • Retrospective review of 30 patients not using the checklist (control group).
  • Comparison of time intervals for post-15-minute ioPTH assay results between groups.

Main Results:

  • The mean time from sample collection to post-15-minute ioPTH result was significantly reduced in the checklist group (22.2 min vs. 33.3 min; P < .01).
  • Proportional operative time spent awaiting ioPTH results decreased significantly with the checklist (24.4% vs. 34.1%; P < .01).
  • Total operative time was significantly reduced for adenomatous disease but not for four-gland hyperplasia.

Conclusions:

  • Implementation of a simple intraoperative checklist effectively reduces ioPTH assay processing time.
  • The checklist contributes to a more efficient surgical workflow in parathyroid surgery.
  • This low-cost intervention shows promise for wider adoption to optimize patient care.