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Emergency workload in otolaryngology
N R Bleach1, P A Williamson, S M Mady
1Department of ENT Surgery, Charing Cross Hospital, London.
Insights
This audit reveals that otolaryngology (ENT) emergencies are a significant workload in district hospitals, with over a quarter of patients needing specialist surgical care. Many cases, particularly in children, could be managed non-operatively, impacting hospital resources.
Area of Science:
- Otolaryngology
- Emergency Medicine
- Hospital Management
Background:
- The otolaryngology (ENT) emergency workload in district general hospitals requires detailed analysis.
- Understanding referral patterns and management needs is crucial for resource allocation.
Purpose of the Study:
- To prospectively audit the ENT emergency workload over a 6-month period.
- To quantify the demand for specialist ENT surgical intervention and identify patient demographics.
Main Methods:
- A prospective audit of all ENT referrals over 6 months.
- Data collection included patient age, referral source, diagnosis, management, and admission status.
- Analysis of the proportion of cases requiring post-fellowship ENT surgeon intervention and operative procedures.
Main Results:
- 742 cases were referred; 26% were children. 69% of referrals originated from the accident and emergency department.
- 40% were discharged, and 27% followed up as outpatients, but 28% required specialist ENT surgeon management.
- 31% of patients were admitted, with 46% of these requiring general anaesthesia for surgery. ENT emergencies constituted 24% of new referrals, 20% of admissions, and 10% of surgical procedures.
Conclusions:
- ENT emergencies represent a substantial component of district general hospital workload, impacting referral numbers, admissions, and surgical procedures.
- While many cases are minor, a significant proportion requires advanced ENT surgical expertise, highlighting the need for appropriate staffing and resources.
- Further analysis could optimize the management of pediatric ENT emergencies and streamline non-operative care pathways.
Abstract:
A 6-month prospective audit of the otolaryngology emergency workload in a district general hospital was undertaken. A total of 742 cases was referred of whom 193 (26%) were children (< 16 years). The male to female ratio was equal, and 69% of cases were referred from the accident and emergency department. Although most conditions were minor enough to be managed in the ward treatment room and either discharged (40%) or followed up as outpatients (27%), more than one-quarter of patients (28%) needed management by a post-fellowship ENT surgeon. Of the patients, 31% (230/742) were admitted, of whom 107 (46%) required an operation under general anaesthesia. The consequent ENT emergency workload represented 24% of all new patient referrals, 20% of ENT ward admissions and 10% of ENT surgical procedures.