TY - JOUR
T1 - Assessing the quality of the management of tonsillitis among Australian children
T2 - a population-based sample survey
AU - Hibbert, Peter
AU - Stephens, Jacqueline H.
AU - de Wet, Carl
AU - Williams, Helena
AU - Hallahan, Andrew
AU - Wheaton, Gavin R.
AU - Dalton, Chris
AU - Ting, Hsuen P.
AU - Arnolda, Gaston
AU - Braithwaite, Jeffrey
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Objective: The aims of this study were twofold: (1) to design and validate a set of clinical indicators of appropriate care for tonsillitis and (2) to measure the level of tonsillitis care that is in line with guideline recommendations in a sample of Australian children. Study Design: A set of tonsillitis care indicators was developed from available national and international guidelines and validated in 4 stages. This research used the same design as the CareTrack Kids study, which was described in detail elsewhere. Setting: Samples of patient records from general practices, emergency departments, and hospital admissions were assessed. Subjects and Methods: Patient records of children aged 0 to 15 years were assessed for the presence of, and adherence to, the indicators for care delivered in 2012 and 2013. Results: Eleven indicators were developed. The records of 821 children (mean age, 5.0 years; SD, 4.0) with tonsillitis were screened. The reviewers conducted 2354 eligible indicator assessments across 1127 visits. Adherence to 6 indicators could be assessed and ranged from 14.3% to 73.2% (interquartile range 31.5% to 72.2%). Conclusion: Our main findings are consistent with the international literature: the treatment of many children who present with confirmed or suspected tonsillitis is inconsistent with current guidelines. Future research should consider how the indicators could be applied in a structured and automated manner to increase the reliability and efficiency of record reviews and help raise clinicians’ awareness of appropriate tonsillitis management.
AB - Objective: The aims of this study were twofold: (1) to design and validate a set of clinical indicators of appropriate care for tonsillitis and (2) to measure the level of tonsillitis care that is in line with guideline recommendations in a sample of Australian children. Study Design: A set of tonsillitis care indicators was developed from available national and international guidelines and validated in 4 stages. This research used the same design as the CareTrack Kids study, which was described in detail elsewhere. Setting: Samples of patient records from general practices, emergency departments, and hospital admissions were assessed. Subjects and Methods: Patient records of children aged 0 to 15 years were assessed for the presence of, and adherence to, the indicators for care delivered in 2012 and 2013. Results: Eleven indicators were developed. The records of 821 children (mean age, 5.0 years; SD, 4.0) with tonsillitis were screened. The reviewers conducted 2354 eligible indicator assessments across 1127 visits. Adherence to 6 indicators could be assessed and ranged from 14.3% to 73.2% (interquartile range 31.5% to 72.2%). Conclusion: Our main findings are consistent with the international literature: the treatment of many children who present with confirmed or suspected tonsillitis is inconsistent with current guidelines. Future research should consider how the indicators could be applied in a structured and automated manner to increase the reliability and efficiency of record reviews and help raise clinicians’ awareness of appropriate tonsillitis management.
KW - child health
KW - guideline adherence
KW - health care quality indicators
KW - patient safety
KW - tonsillitis
UR - http://www.scopus.com/inward/record.url?scp=85053406658&partnerID=8YFLogxK
U2 - 10.1177/0194599818796137
DO - 10.1177/0194599818796137
M3 - Article
C2 - 30149777
AN - SCOPUS:85053406658
SN - 0194-5998
VL - 160
SP - 137
EP - 144
JO - Otolaryngology - Head and Neck Surgery (United States)
JF - Otolaryngology - Head and Neck Surgery (United States)
IS - 1
ER -