手术仪表板的实施及其对小儿扁桃体切除术结果的影响：质量改进研究

IF 1.6 4区医学 Q2 OTORHINOLARYNGOLOGY Laryngoscope Investigative Otolaryngology Pub Date : 2024-09-14 DOI:10.1002/lio2.1315

Quynh-Chi L. Dang BA, BS, Emily Román MPAS, PA-C, Kimberly Donner MPAS, PA-C, Emily Carsey BSN, MSHA, Ron F. Mitchell MD, Stephen R. Chorney MD MPH, Romaine F. Johnson MD, MPH

{"title":"手术仪表板的实施及其对小儿扁桃体切除术结果的影响：质量改进研究","authors":"Quynh-Chi L. Dang BA, BS, Emily Román MPAS, PA-C, Kimberly Donner MPAS, PA-C, Emily Carsey BSN, MSHA, Ron F. Mitchell MD, Stephen R. Chorney MD MPH, Romaine F. Johnson MD, MPH","doi":"10.1002/lio2.1315","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>In pediatric tonsillectomy management, the consistent tracking of surgical outcomes and adherence to guidelines are vital. This study explores how a surgical dashboard can serve as a tool in research analysis, translating AAO-HNSF guidelines into measurable performance improvements.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Using a prospective registry from three pediatric hospitals, a Tableau dashboard was constructed to graphically visualize key demographic and postoperative outcomes (including intensive care unit [ICU] utilization, 30-day emergency department (ED) visits, and postoperative bleed rates) in children undergoing tonsillectomy from 2020 to 2024. From the dashboard data, a retrospective cohort study analyzing 6767 tonsillectomies was conducted from January 2, 2020, to June 20, 2023. Patients were categorized into low-risk, OSA-only (by ICD-10 codes), and high-risk groups based on comorbidities. Logistic regression identified factors influencing ED revisits and unplanned nursing calls. Three quality initiatives were assessed: preoperative school absence notes, perioperative dexamethasone recording, and post-tonsillectomy parental education.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 2122 (31%) were low-risk, 2648 (39%) were OSA-only, and 1997 (30%) high risk. Risk factors that increased the likelihood of ED visits were high-risk comorbidities (OR = 1.46; 95% CI = 1.24–1.74; <i>p</i> < 0.001) and older age (OR = 1.05; 95% CI = 1.03–1.08; <i>p</i> < 0.001). Risk factors that increased the likelihood of an unplanned nursing communication were high-risk comorbidities (OR = 1.53; 95% CI = 1.34–1.75; <i>p</i> < 0.001), older age (OR = 1.03, 95% CI = 1.01–1.04; <i>p</i> = 0.001), and Medicaid insurance (OR = 1.25; 95% CI = 1.09–1.43; <i>p</i> = 0.002). Postoperative bleed control was generally comparable between the groups, at 2.8% (low risk), 2.7% (OSA), 3.2 (high risk) (<i>p</i> = 0.651).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>The dashboard aided in data collection, data visualization, and data analysis of quality improvement initiatives, effectively translating guidelines into tangible measures to enhance care.</p>\n </section>\n \n <section>\n \n <h3> Level of evidence</h3>\n \n <p>NA.</p>\n </section>\n </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"9 5","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.1315","citationCount":"0","resultStr":"{\"title\":\"Implementation and impact of a surgical dashboard on pediatric tonsillectomy outcomes: A quality improvement study\",\"authors\":\"Quynh-Chi L. Dang BA, BS, Emily Román MPAS, PA-C, Kimberly Donner MPAS, PA-C, Emily Carsey BSN, MSHA, Ron F. Mitchell MD, Stephen R. Chorney MD MPH, Romaine F. Johnson MD, MPH\",\"doi\":\"10.1002/lio2.1315\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Introduction</h3>\\n \\n <p>In pediatric tonsillectomy management, the consistent tracking of surgical outcomes and adherence to guidelines are vital. This study explores how a surgical dashboard can serve as a tool in research analysis, translating AAO-HNSF guidelines into measurable performance improvements.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Using a prospective registry from three pediatric hospitals, a Tableau dashboard was constructed to graphically visualize key demographic and postoperative outcomes (including intensive care unit [ICU] utilization, 30-day emergency department (ED) visits, and postoperative bleed rates) in children undergoing tonsillectomy from 2020 to 2024. From the dashboard data, a retrospective cohort study analyzing 6767 tonsillectomies was conducted from January 2, 2020, to June 20, 2023. Patients were categorized into low-risk, OSA-only (by ICD-10 codes), and high-risk groups based on comorbidities. Logistic regression identified factors influencing ED revisits and unplanned nursing calls. Three quality initiatives were assessed: preoperative school absence notes, perioperative dexamethasone recording, and post-tonsillectomy parental education.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>A total of 2122 (31%) were low-risk, 2648 (39%) were OSA-only, and 1997 (30%) high risk. Risk factors that increased the likelihood of ED visits were high-risk comorbidities (OR = 1.46; 95% CI = 1.24–1.74; <i>p</i> < 0.001) and older age (OR = 1.05; 95% CI = 1.03–1.08; <i>p</i> < 0.001). Risk factors that increased the likelihood of an unplanned nursing communication were high-risk comorbidities (OR = 1.53; 95% CI = 1.34–1.75; <i>p</i> < 0.001), older age (OR = 1.03, 95% CI = 1.01–1.04; <i>p</i> = 0.001), and Medicaid insurance (OR = 1.25; 95% CI = 1.09–1.43; <i>p</i> = 0.002). Postoperative bleed control was generally comparable between the groups, at 2.8% (low risk), 2.7% (OSA), 3.2 (high risk) (<i>p</i> = 0.651).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>The dashboard aided in data collection, data visualization, and data analysis of quality improvement initiatives, effectively translating guidelines into tangible measures to enhance care.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Level of evidence</h3>\\n \\n <p>NA.</p>\\n </section>\\n </div>\",\"PeriodicalId\":48529,\"journal\":{\"name\":\"Laryngoscope Investigative Otolaryngology\",\"volume\":\"9 5\",\"pages\":\"\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-09-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.1315\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Laryngoscope Investigative Otolaryngology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/lio2.1315\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"OTORHINOLARYNGOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Laryngoscope Investigative Otolaryngology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/lio2.1315","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}

引用次数: 0

摘要

导言：在小儿扁桃体切除术管理中，持续跟踪手术结果和遵守指南至关重要。本研究探讨了手术仪表盘如何作为研究分析工具，将 AAO-HNSF 指南转化为可衡量的绩效改进。方法利用三家儿科医院的前瞻性登记资料，构建了一个 Tableau 面板，以图形直观地显示 2020 年至 2024 年接受扁桃体切除术的儿童的主要人口统计学和术后结果（包括重症监护室 [ICU] 使用率、30 天急诊科 (ED) 就诊率和术后出血率）。根据仪表板数据，我们对 2020 年 1 月 2 日至 2023 年 6 月 20 日期间的 6767 例扁桃体切除术进行了回顾性队列研究分析。根据合并症将患者分为低风险组、纯 OSA 组（按 ICD-10 编码）和高风险组。逻辑回归确定了影响急诊室复诊和非计划护理呼叫的因素。对三项质量措施进行了评估：术前缺课记录、围手术期地塞米松记录和扁桃体切除术后家长教育。结果共有 2122 例（31%）为低风险，2648 例（39%）为纯 OSA，1997 例（30%）为高风险。增加急诊室就诊可能性的风险因素是高风险合并症（OR = 1.46; 95% CI = 1.24-1.74; p <0.001）和年龄较大（OR = 1.05; 95% CI = 1.03-1.08; p <0.001）。高风险合并症（OR = 1.53；95% CI = 1.34-1.75；p <；0.001）、高龄（OR = 1.03，95% CI = 1.01-1.04；p = 0.001）和医疗补助保险（OR = 1.25；95% CI = 1.09-1.43；p = 0.002）是增加非计划护理沟通可能性的风险因素。各组的术后出血控制率基本相当，分别为 2.8%（低风险）、2.7%（OSA）、3.2（高风险）（P = 0.651）。结论该仪表板有助于数据收集、数据可视化和质量改进措施的数据分析，有效地将指南转化为加强护理的具体措施。证据级别 NA。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

摘要图片

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

Implementation and impact of a surgical dashboard on pediatric tonsillectomy outcomes: A quality improvement study

Introduction

In pediatric tonsillectomy management, the consistent tracking of surgical outcomes and adherence to guidelines are vital. This study explores how a surgical dashboard can serve as a tool in research analysis, translating AAO-HNSF guidelines into measurable performance improvements.

Methods

Using a prospective registry from three pediatric hospitals, a Tableau dashboard was constructed to graphically visualize key demographic and postoperative outcomes (including intensive care unit [ICU] utilization, 30-day emergency department (ED) visits, and postoperative bleed rates) in children undergoing tonsillectomy from 2020 to 2024. From the dashboard data, a retrospective cohort study analyzing 6767 tonsillectomies was conducted from January 2, 2020, to June 20, 2023. Patients were categorized into low-risk, OSA-only (by ICD-10 codes), and high-risk groups based on comorbidities. Logistic regression identified factors influencing ED revisits and unplanned nursing calls. Three quality initiatives were assessed: preoperative school absence notes, perioperative dexamethasone recording, and post-tonsillectomy parental education.

Results

A total of 2122 (31%) were low-risk, 2648 (39%) were OSA-only, and 1997 (30%) high risk. Risk factors that increased the likelihood of ED visits were high-risk comorbidities (OR = 1.46; 95% CI = 1.24–1.74; p < 0.001) and older age (OR = 1.05; 95% CI = 1.03–1.08; p < 0.001). Risk factors that increased the likelihood of an unplanned nursing communication were high-risk comorbidities (OR = 1.53; 95% CI = 1.34–1.75; p < 0.001), older age (OR = 1.03, 95% CI = 1.01–1.04; p = 0.001), and Medicaid insurance (OR = 1.25; 95% CI = 1.09–1.43; p = 0.002). Postoperative bleed control was generally comparable between the groups, at 2.8% (low risk), 2.7% (OSA), 3.2 (high risk) (p = 0.651).

Conclusion

The dashboard aided in data collection, data visualization, and data analysis of quality improvement initiatives, effectively translating guidelines into tangible measures to enhance care.