Assessment of acute otitis externa and otitis media with effusion performance measures in otolaryngology practices

Abstract

Although compliance in this study was generally high across both measure sets, actual use of the face sheet forms for appropriate patients was lower than the 80% reporting mandate by the Centers for Medicare and Medicaid Services that allows physicians to receive the monetary bonus. Incentive-based reporting should be continuously investigated to assess challenges for evaluating current measures.

Understanding Quality Measures in Otolaryngology–Head and Neck Surgery

“…This finding may be the result, in part, of a failure in documentation since this study was conducted by using a review of medical records. However, a study by Patel et al 27 that surveyed otolaryngologists on how they diagnosed otitis media with effusion found that 25 of 29 of the respondents (86.2%) reported using pneumatic otoscopy or tympanometry to make the diagnosis, meaning that at least 1 of 10 otolaryngologists surveyed did not follow the guidelines. This is but one example of how performance measures may highlight areas in which we are not following our own evidence-based guidelines.…”

An easy method for fitting conventional endoscopes for pneumatic video Otoscopy

“…As mentioned above, pneumatic endoscopy is mostly performed on children with serous otitis media, often by pediatricians 1–5. It might sometimes be used as a diagnostic substitute for tympanometry.…”

“…Pneumatic otoscopy might be a helpful diagnostic tool for certain middle ear diseases. According to the literature it is mostly used in the pediatric practice or by the pediatric otologist for making the diagnosis of serous otitis media 1–5. However, the method offers more possibilities as we will show.…”

Patient Safety/Quality Improvement Primer, Part I: What PS/QI Means to Your Otolaryngology Practice

“…18 Despite a multidisciplinary evidence-based approach, only one-third of pediatric practices documented adherence to this performance measure, 19 and 14% of otolaryngologists surveyed do not adhere to this standard. 20 Experience has shown that CPGs may be slow to translate into desired outcomes when practices are entrenched. A 2017 study demonstrated a 3- to 4-fold increased likelihood (odds ratio) of antihistamine, antibiotic, and intranasal steroid administration when otitis media with effusion is diagnosed, despite guidelines to the contrary.…”

“…Performance measures are used to quantify how often an evidence‐based desired practice is performed 15 —for example, using tympanometry or pneumatic otoscopy to diagnose otitis media with effusion in children 18 . Despite a multidisciplinary evidence‐based approach, only one‐third of pediatric practices documented adherence to this performance measure, 19 and 14% of otolaryngologists surveyed do not adhere to this standard 20 . Experience has shown that CPGs may be slow to translate into desired outcomes when practices are entrenched.…”