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Implementing a guideline for acute tonsillitis using an ambulatory medical unit

Published online by Cambridge University Press:  10 April 2019

C Perkins ,
F Ray Brown ,
K Pohl ,
O McLaren ,
J Powles  and
R Thorley
C Perkins*
Affiliation:
Department of ENT, Torbay and South Devon NHS Foundation Trust, Torquay, UK
F Ray Brown
Affiliation:
Department of ENT, Torbay and South Devon NHS Foundation Trust, Torquay, UK
K Pohl
Affiliation:
Department of ENT, Torbay and South Devon NHS Foundation Trust, Torquay, UK
O McLaren
Affiliation:
Department of ENT, Torbay and South Devon NHS Foundation Trust, Torquay, UK
J Powles
Affiliation:
Department of ENT, Torbay and South Devon NHS Foundation Trust, Torquay, UK
R Thorley
Affiliation:
Department of ENT, Torbay and South Devon NHS Foundation Trust, Torquay, UK
*
Author for correspondence: Miss Clare Perkins, Department of ENT, Torbay Hospital, Newton Road, Torquay Devon TQ2 7AA E-mail: clare.perkins1@nhs.net
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Abstract

Objective

Acute tonsillitis represents a significant proportion of admissions to ENT departments nationally. Given current hospital pressures, it is vital to look for safe alternatives to admission. This study explores the safe management of patients in an ambulatory medical unit, without the need for admission.

Methods

A retrospective review of 48 patients’ notes was carried out. Following the development and implementation of a guideline for acute tonsillitis, a prospective re-audit of 41 patients was carried out, measuring length of stay, overnight admissions and re-admissions.

Results

The rate of overnight admission following implementation of the guideline fell from 0.75 to 0.29, and average length of stay dropped from 19.2 to 9.5 hours. There were two re-admissions in each cycle of the audit, which represents a non-significant increase.

Conclusion

The tonsillitis guideline has significantly reduced admissions and length of stay. Re-admissions remain low, demonstrating that this is a safe and cost-effective intervention.

Keywords

TonsillitisPatient AdmissionLength Of Stay
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 5 , May 2019 , pp. 386 - 389
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Miss C Perkins takes responsibility for the integrity of the content of the paper

Presented at the South West Regional Audit Meeting, 26 January 2018, Exeter, UK.

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