Patient Safety and Quality Improvement in Otolaryngology Education: A Systematic Review

Abstract

Objective The breadth and depth of patient safety/quality improvement (PS/QI) research dedicated to otolaryngology-head and neck surgery (OHNS) education remains unknown. This systematic review aims to define this scope and to identify knowledge gaps as well as potential areas of future study to improved PS/QI education and training in OHNS. Data Sources A computerized Ovid/Medline database search was conducted (January 1, 1965, to May 15, 2015). Similar computerized searches were conducted using Cochrane Database, PubMed, and Google Scholar. Review Methods The study protocol was developed a priori using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Articles were classified by year, subspecialty, Institute of Medicine (IOM) Crossing the Chasm categories, and World Health Organization (WHO) subclass. Results Computerized searches yielded 8743 eligible articles, 267 (3.4%) of which met otolaryngology PS/QI inclusion criteria; 51 (19%) were dedicated to resident/fellow education and training. Simulation studies (39%) and performance/competency evaluation (23.5%) were the most common focus. Most projects involved general otolaryngology (47%), rhinology (18%), and otology (16%). Classification by the IOM included effective care (45%), safety/effective care (41%), and effective and efficient care (7.8%). Most research fell into the WHO category of "identifying solutions" (61%). Conclusion Nineteen percent of OHNS PS/QI articles are dedicated to education, the majority of which are simulation and focus on effective care. Knowledges gaps for future research include facial plastics PS/QI and the WHO category of "studies translating evidence into safer care."

Impact of a Formal Patient Safety and Quality Improvement Curriculum: A Prospective, Controlled Trial

“…Now that education and experience in PSQI is mandated by the ACGME, otolaryngology faculty must determine how best to meet this requirement. A recent systematic review of PSQI education in otolaryngology demonstrated an increase in publications of PSQI projects related to resident education since 2008 . Interestingly, none of the articles in this series pertained to formally integrated curricula on the fundamentals of PSQI.…”

“…A recent systematic review of PSQI education in otolaryngology demonstrated an increase in publications of PSQI projects related to resident education since 2008. 29 Interestingly, none of the articles in this series pertained to formally integrated curricula on the fundamentals of PSQI. In fact, only a small number of the articles focused on integrating PSQI otolaryngology resident educational curricula.…”

Patient Safety and Quality Improvement in Otolaryngology–Head and Neck Surgery: A Systematic Review

“…The study protocol using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) process 6,7 was previously published by our team 5 : An information specialist assisted in the development of subject headings outlined in Table I. Computerized Ovid/Medline, EMBASE, PubMed, and Cochrane database searches were performed from January 1, 1965, through September 30, 2019.…”

“…Outcome variables were defined a priori and previously outlined in our education study. 5 In brief, associated study design information and otolaryngology subspecialty were recorded in the Excel (Microsoft Corp., Redmond, WA) database, version 2013. As the data was analyzed, broad focus areas were identified into which studies could be further categorized.…”

“…Residency/education (n = 92, 12.5%) ranked third; we previously provide an in-depth look at this category through 2015 in our pilot study. 5 Any study that examined multiple IOM aims of care were noted as such (Fig. 5).…”