利用NSQIP-P识别儿科耳鼻喉科质量改进的最大机会领域。

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中文摘要

背景： 国家儿科耳鼻喉科实践模式可以突出高收益的质量改进机会。我们的目标是通过美国外科医师学会国家外科质量改进计划-儿科（NSQIP-P）识别对针对性质量倡议具有最大潜在影响的手术。方法：使用2021-2023年NSQIP-P参与者使用文件，我们识别了所有在耳鼻喉科和儿科耳鼻喉科下提交的、年病例数超过5例的当前 procedural terminology（CPT）代码。手术按类型分组，并使用帕累托分析确定高容量目标。结果：在2021-2023年间，代表91个CPT代码的52,490例病例符合纳入标准。七种手术占病例量的80%，包括伴或不伴乳突切除术的鼓室成形术（22.1%）、气道内窥镜检查（19.1%）、人工耳蜗植入（10%）、内窥镜鼻窦手术（10%）、先天性颈部囊肿切除术（8.8%）和腭成形术（6.5%）。结论：儿科耳鼻喉科实践高度集中在少数手术中。将质量改进工作集中在这些高容量手术上，可能会对减少变异和优化结果产生最大影响。

英文摘要

National pediatric otolaryngology practice patterns can highlight high-yield opportunities for quality improvement. Our objective was to identify procedures with the greatest potential impact for targeted quality initiatives using the ACS National Surgical Quality Improvement Program-Pediatric (NSQIP-P). Using the 2021-2023 NSQIP-P Participant Use Files, we identified all Current Procedural Terminology (CPT Codes) submitted under otolaryngology and pediatric otolaryngology with more than five annual cases. Procedures were grouped by type, and a Pareto analysis was used to determine high-volume targets. Across 2021-2023, 52,490 cases representing 91 CPT codes met inclusion criteria. Seven procedures accounted for 80% of case volume, including tympanoplasty with or without mastoidectomy (22.1%), airway endoscopy (19.1%), cochlear implantation (10%), endoscopic sinus surgery (10%), congenital neck cyst resection (8.8%), and palatoplasty (6.5%). Pediatric otolaryngology practice is highly concentrated in a small number of procedures. Focusing quality improvement efforts on these high-volume surgeries may yield the greatest impact on reducing variation and optimizing outcomes.