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
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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. 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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). 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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.
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