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Summary
Paediatric tonsillectomy and adenoidectomy are the most common surgical procedures in childhood, usually for obstructed sleep apnoea or frequent tonsillitis. However, rates of tonsillectomy vary greatly depending on location.
Around 70 hospitals in Victoria perform tonsillectomies and adenoidectomies. Our data shows around 10% of hospitals have readmission rates higher than expected for these surgeries.
In this video, A/Prof Gillian Nixon gives insights into the geographical variation of paediatric adenoidectomy rates across Victoria, and potential contributing factors.
Outcome
Making a decision about tonsillectomy
Our consumer videos and fact sheets aim to support families making a decision about tonsillectomy, and help them understand what to expect if tonsil surgery is required.
Resources to support general practitioners in shared decision making with families were introduced in November 2018, as part of the Statewide Paediatric HealthPathways Project, a Safer Care Victoria and Tasmanian Primary Health Network Alliance Partnership:
- Snoring and Obstructive Sleep Apnoea in Children HealthPathway
- Sore Throat in Children HealthPathway
Reducing readmission rates after tonsil surgery
We partnered with five hospitals to introduce a quality improvement project to reduce readmission rates after tonsil surgery, particularly for pain and dehydration. We developed consumer and clinician resources for health services to use to help families understand what to expect before coming to hospital and at home after their child’s surgery:
- Fact sheets – helps families to understand what to expect on the day of tonsil surgery and in the days after this surgery
- Pain management plan after tonsil surgery - helps families to understand what medication to give their child after tonsil surgery at home, and when, along with other tips to help manage their child’s pain
- Telephone script - helps clinicians to provide advice when calling families to follow up on how their child is recovering and to troubleshoot any issues, ideally on day four after surgery when the pain is likely to be worse.
Targets
- Reduced rate of tonsillectomy with or without adenoidectomy within the pilot primary health network site
- Reduced readmission rates for children following tonsillectomy with or without adenoidectomy
Measures
- Readmission rates after tonsillectomy in five participating pilot health services.
- Use and consumer satisfaction with the consumer resources in the pilot primary health network.