Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P118

PSQI

P118
Otolaryngology-Head and Neck Surgery 163(1S)
Presentation schedule is subject to change. The Official Program Abstracts supplement does not reflect changes made after August 10, 2020.
Methods: A cross-sectional survey of 12 academic otolar81% of patients agreed that inclusion of residents improved
yngology programs assessed well-being and burnout in resithe quality of their care.
dents, fellows, and faculty using the Expanded Physician
Conclusions: The role of a resident surgeon in otolaryngologic
Well-being Index (ePWBI) and Maslach Burnout Inventory
procedures may be unclear to patients regardless of the patient's
(MBI-2).
background or type of surgery performed. Informational handResults: Of 613 surveys sent to academic otolaryngology
outs may help bridge this knowledge gap and improve patient
residents, fellows, and faculty, 340 were completed (55.5%).
attitudes toward resident participation in their care.
Using the MBI-2, burnout was identified in 30% of all participants, 35% of trainees, and 26% of faculty (P = .06).
Predictors and Long-term Outcomes for
Using the ePWBI, poor well-being was identified in 44% of
Abbreviated Admission Pathway in Free
all participants, 49% of trainees, and 40% of faculty memFlaps for Elderly Patients
bers (P = .10). Burnout was present in 28% of male trainees
Anvesh Reddy Kompelli, MD (Presenter); Amanda
and 48% of female trainees (P = .024). Female trainees
Ederle, MS; Victoria Gau; Emre A. Vural, MD; Maya
reported higher emotional exhaustion than male trainees
Merriweather; Mauricio A. Moreno-Vera, MD
(P < .001), although there was no significant difference in
Objectives: Previous studies have independently reported on
depersonalization (P = .32). Female trainees had poorer
abbreviated length of stay (ALoS) protocols for head and neck
well-being compared with male trainees (P < .001). Burnout
free flap (HNFF) reconstruction, as well as free flap outcomes
was present in 27% of male faculty compared with 15% of
in the elderly. At our institution, we have established an agefemale faculty (P = .10), with no significant differences in
and comorbidity-agnostic ALoS pathway and sought to report
well-being scores (P = .37). For faculty and trainees,
on its feasibility and outcomes in this subset of patients.
increased number of on-call nights and hours worked corMethods: A retrospective chart review of all HNFF patients
related with burnout and poor well-being. Staff with good
over 80 years, treated at an academic tertiary institution between
well-being had more years of practice (P = .04) and lower
December 2009 and September 2019. Demographics, comorstudent loan debt (P = .05).
bidities, and surgical data were retrieved. Because the ALoS proConclusions: Longer working hours and more nights on call
tocol aims to discharge all patients on postoperative day (POD)
are detrimental to well-being and increase burnout. Female
5, this was the main end point for statistical analysis. Readmission
trainees have higher levels of burnout and poorer well-being.
and discharge on POD 7 were secondary outcomes.
Faculty with more years of experience and less student loan
Results: A total of 48 patients were identified on chart
debt have better well-being.
review, with a mean age of 83 years (80-95 years). Patients
were predominately male (65%) and white (91%).
Quality Improvement Initiative to Improve
Hypertension (71%) and diabetes (36%) were the most comCommunication for Acutely Aphonic Patients
mon comorbidities, with 92.5% of patients being American
Catherine T. Haring, MD (Presenter); Kaitlin Vance;
Society of Anesthesiologists class 3 or less. Flap-related surMarie Anna Leginza; Janice Farlow, MD; Robert J.
gical reexploration was needed in 7% of the cases, with an
Morrison, MD; Keith A. Casper, MD
overall flap viability of 97% for the series. All patients were
Objectives: Surgical procedures that lead to the acute inabilsuccessfully managed in our head and neck intermediate care
ity
to speak may affect patient quality of life and safety. We
unit, with no patients requiring intensive care unit admission.
sought
to characterize the impact of iatrogenic acute aphonia
Only 30% of patients were discharged by POD 5, and an
and
to
implement an electronic communication application
additional 40% of patients were discharged by POD 7. The
postoperatively.
observed 30-day readmission for the cohort was 35%.
Methods: Subjects included hospitalized patients who
Conclusions: Although an ALoS pathway for HNFF is appliacutely
lost the ability to speak because of tracheostomy or
cable to elderly patients, its benefits pale when compared with
total
laryngectomy
from April 2018 to December 2019. We
a younger cohort. A low percentage of patients achieve the
distributed
questions
regarding the patient communication
goal of early discharge. This observation, combined with a
experience
and
relevant
questions from the validated voicehigh readmission rate, suggests that a dedicated pathway
related
quality-of-life
(VRQOL)
questionnaire. Patients were
should be implemented for these patients.
offered a tablet with Verbally, a communication application.
Pre- and postintervention groups were compared with chiPredictors of Otolaryngology Physician
square analyses.
Well-being and Burnout
Results: Surveys were completed by 35 patients (n = 8 preDavid P. Larson, MD (Presenter); Matthew L.
and n = 17 postintervention). Of the preintervention patients,
Carlson, MD; Erin K. O'Brien, MD; Christine Lohse, MS;
89% reported trouble communicating postoperatively. Specific
Garret W. Choby, MD
communication topics included breathing or suctioning (56%),
Objectives: Poor well-being and burnout are present in a
treatment or discharge plans (78%), and/or immediate needs
troubling number of physicians. We aimed to identify
including pain and need to use the bathroom (39%). Ninety-two
-personal and professional factors associated with otolarynpercent of patients were interested in using an electronic comgology physician well-being and burnout.
munication device. Communication difficulties caused anxiety

Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts

Table of Contents for the Digital Edition of Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts