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Type: Journal article
Title: Assessing the quality of the management of tonsillitis among Australian children: a population-based sample survey
Author: Hibbert, P.
Stephens, J.
de Wet, C.
Williams, H.
Hallahan, A.
Wheaton, G.
Dalton, C.
Ting, H.
Arnolda, G.
Braithwaite, J.
Citation: Otolaryngology - Head and Neck Surgery, 2019; 160(1):137-144
Publisher: SAGE Publications
Issue Date: 2019
ISSN: 0194-5998
Statement of
Peter Hibbert, Jacqueline H. Stephens, Carl de Wet, Helena Williams, Andrew Hallahan, Gavin R. Wheaton, Chris Dalton, Hsuen P. Ting, Gaston Arnolda and Jeffrey Braithwaite
Abstract: 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.
Keywords: Tonsillitis; patient safety; guideline adherence; health care quality indicators; child health
Rights: © American Academy of Otolaryngology–Head and Neck Surgery Foundation 2018. Reprints and permission:
RMID: 0030099048
DOI: 10.1177/0194599818796137
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Appears in Collections:Paediatrics publications

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