An innovative approach to improve ear, nose and throat surgical access for remote living Cape York Indigenous children
| Autor: | Denise Newman, Deborah Dean, Ann Richards, Susan P. Jacups, Kate M. McConnon |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Telemedicine 020205 medical informatics Hearing loss Service delivery framework Specialty 02 engineering and technology Telehealth Audiology 03 medical and health sciences 0302 clinical medicine Audiometry Hearing Health care otorhinolaryngologic diseases 0202 electrical engineering electronic engineering information engineering medicine Health Services Indigenous Humans 030212 general & internal medicine Elective surgery Child Hearing Loss medicine.diagnostic_test business.industry General Medicine medicine.disease Otitis Media Otorhinolaryngology Child Preschool Pediatrics Perinatology and Child Health Female Medical emergency medicine.symptom business |
| Zdroj: | International journal of pediatric otorhinolaryngology. 100 |
| ISSN: | 1872-8464 |
| Popis: | Introduction On a background of high rates of severe otitis media (OM) with associated hearing loss, children from the Torres Strait and Cape York region requiring ear, nose and throat (ENT) surgery, faced waiting times exceeding three years. After numerous clinical safety incidents were raised, indicating a failure of the current system to deliver appropriate care, the governing Hospital and Health service opted to deliver surgical care through an alternate process. ENT surgeries were performed on 16 consented children from two remote locations via the private health care system, funded by a health provider partnership. Methods We examined the collaboration processes alongside clinical findings from this ENT surgery. Collated patient data, included patient demographics, clinical and audiometry presentation features were reviewed and compared pre and post-operatively. Cost savings associated with the use of TeleHealth post-operatively were briefly examined. Results Surgeries were successfully completed in all 16 children. The reported mean waitlist time for ENT surgery was 1.2 years. Pre-surgery pure-tone average hearing thresholds were reported at left: 30.9 dB, right: 38.2 dB. The majority of presentations were for bilateral OM with Effusion (69%). Post-surgical follow up indicated successful clinical outcomes in 80% of patients and successful hearing outcomes in 88% of patients. Mean difference pure-tone average hearing thresholds, left: 8.4 dB and right: 11.2 dB. Furthermore, the majority of patients reported improved hearing and breathing. The use of TeleHealth for post-operative review enabled a minimum cost saving of AUD$21,664 for these 16 children. Overall, a high level of staffing resources was required to successfully coordinate this intense surgical activity. Conclusion This innovative approach to a health system crisis enabled successful ENT surgical and hearing outcomes in 16 children, whose waitlisted time grossly exceeded state health recommendations. Using private health facilities funded by a health partnership, while unlikely to be a suitable model of care for routine service delivery; may be applied as an adjunct service model when blockages and delays lead to sub-standard service provision. This approach may be applicable to other health care facilities when facing extended elective surgery wait times in ENT or other specialty areas. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect