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Patient Safety and Quality Improvement in Otolaryngology–Head and Neck Surgery: A Systematic Review
Author(s) -
Gettelfinger John D.,
Paulk P. Barrett,
Schmalbach Cecelia E.
Publication year - 2021
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.28538
Subject(s) - subspecialty , medicine , otorhinolaryngology , medline , systematic review , health care , family medicine , patient safety , medical physics , surgery , political science , law , economics , economic growth
Objective The current landscape of patient safety/quality improvement (PS/QI) research dedicated to Otolaryngology–Head and Neck Surgery (OHNS) has not been established. This systematic review aims to define the breadth and depth of PS/QI research dedicated to OHNS and to identify knowledge gaps as well as potential areas of future study. Methods The study protocol was developed a priori using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) process. A computerized Ovid/Medline database search was conducted (January 1, 1965–September 30, 2019). Similar computerized searches were conducted using Cochrane Database, PubMed, and Google Scholar. Articles were classified by year, subspecialty, PS/QI category, Institute of Medicine (IOM) Crossing the Chasm categories, and World Health Organization (WHO) subclass. Results Computerized searches yielded 11,570 eligible articles, 738 (6.4%) of which met otolaryngology PS/QI inclusion criteria; 178 (24.1%) were not specific to any one subspecialty. The most prevalent subspecialty foci were head and neck (29.9%), pediatric otolaryngology (16.9%), and otology/neurotology (11.0%). Studies examining complications or risk factors (32.0%) and outcomes/quality measures (16.3%) were the most common foci. Classification by the IOM included effective care (31.4%), safety (29.9%), and safety/effective care (25.3%). Most research fell into the WHO categories of understanding causes (28.5%) or measuring harm (28.3%). Conclusion Most OHNS PS/QI projects (32.0%) focus on reporting complications or risk factors, followed by outcomes/quality measures (16.3%). Knowledges gaps for future research include healthcare disparities, multidisciplinary care, and the WHO category of studies translating evidence into safer care. Level of Evidence NA Laryngoscope , 131:33–40, 2021