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Streamlining grommet pathways for otitis media with effusion and hearing loss in children: our experience

  • O McLaren (a1), E C Toll (a1), R Easto (a2), E Willis (a3), S Harris (a3) and J Rainsbury (a4)...

Abstract

Background

Grommet insertion is a common surgical procedure in children. Long waiting times for grommet insertion are not unusual. This project aimed to streamline the process by introducing a pathway for audiologists to directly schedule children meeting National Institute for Health and Care Excellence Clinical Guideline 60 (‘CG60’) for grommet insertion.

Method and results

A period from June to November 2014 was retrospectively audited. Mean duration between the first audiology appointment and grommet insertion was 294.5 days (median = 310 days). Implementing the direct-listing pathway reduced the duration between first audiology appointment and grommet insertion (mean = 232 days; median = 231 days). There has been a reduction in the time between the first audiology appointment and surgery (mean difference of 62.5 days; p = 0.024), and a reduction in the time between second audiology appointment and surgery (28 days; p = 0.009).

Conclusion

Direct-listing pathways for grommet insertion can reduce waiting times and expedite surgery. Implementation involves a simple alteration of current practice, adhering to National Institute for Health and Care Excellence Clinical Guideline 60. The ultimate decision regarding surgery still rests with ENT specialists.

Copyright

Corresponding author

Author for correspondence: Mr Oliver McLaren, Department of Otolaryngology, Torbay Hospital, Lawes Bridge Road, Torquay TQ2 7AA, UK E-mail: oliver.mclaren@nhs.net

Footnotes

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Mr O McLaren takes responsibility for the integrity of the content of the paper

Footnotes

References

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1Hospital Episode Statistics: Admitted Patient Care – Procedures and Interventions (2014–15). NHS Digital. In: http://content.digital.nhs.uk/statisticsa-z [15 October 2016]
2Berkman, ND, Wallace, IF, Steiner, MJ, Harrison, M, Greenblatt, AM, Lohr, KN et al. Otitis Media With Effusion: Comparative Effectiveness of Treatments, Report No.: 13-EHC091-EF; AHRQ Comparative Effectiveness Reviews. Rockville, MD: Agency for Healthcare Research and Quality, 2013
3American Academy of Family Physicians; American Academy of Otolaryngology-Head and Neck Surgery; American Academy of Pediatrics Subcommittee on Otitis Media With Effusion. Otitis media with effusion. Pediatrics 2004;113:1412–29
4Lous, J, Burton, MJ, Felding, JU, Ovesen, T, Rovers, MM, Williamson, I. Grommets (ventilation tubes) for hearing loss associated with otitis media with effusion in children. Cochrane Database Syst Rev 2005;(25):CD001801
5National Institute for Health and Care Excellence. Otitis media with effusion in under 12s: surgery (Clinical guideline CG60). In: https://www.nice.org.uk/guidance/cg60 [12 July 2017]
6Ballini, L, Negro, A, Maltoni, S, Vignatelli, L, Flodgren, G, Simera, I et al. Interventions to reduce waiting times for elective procedures. Cochrane Database Syst Rev 2015;(2):CD005610

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