Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P263

Poster Presentations	

In Situ Simulation for Improving Adult
Tracheostomy Patient Safety
Sadia Ahmed (Presenter); Cristen Cusumano, MD;
Sharan J. Shah; Anthony Ma; Christina J. Yang, MD
Objectives: To implement in situ simulation to improve
adult tracheostomy care and patient safety on inpatient
wards.
Methods: A prospective quality improvement (QI) study to
assess latent safety threats (LSTs) related to adult tracheostomy
care management was conducted in a tertiary care inpatient
medicine unit. LSTs were identified through equipment
checklists and team performance on in situ simulation of an
obstructed tracheostomy tube. Simulation outcomes included
structured debriefs, video ratings of team performance, and
participant self-assessment of confidence regarding tracheostomy care and emergencies. Weekly reassessment included a
6-point bedside equipment checklist (obturator, inner cannula,
same-size tracheostomy tube, suction catheter and canister,
and bag-valve mask). LSTs and interventions were outlined
in an action plan, with provider education and equipment
access interventions implemented in plan-do-study-act cycles.
Equipment checklist and the simulation will be repeated in 3to 6-month intervals.
Results: LSTs identified included lack of equipment such as
suction catheters and same-size spare tracheostomy tubes at
bedside. Backup same-size tracheostomy tube was present at
bedside 33%, 63%, and 80% of the time in months 1 to 3, prior
to any intervention. Over 3 months, 13% of patients had
6 equipment checklist items at bedside. Provider confidence
in managing tracheostomy-related emergencies was also low
(mean score 2.8/5).
Conclusions: In situ simulation can be a useful QI tool for
both education and assessment in identifying and surveilling
LSTs related to tracheostomy care.
Length of Stay in Head and Neck Cancer
Patients
Katherine Webb (Presenter); Tam T. Ramsey; Lisa T.
Galati, MD
Objectives: We investigate the impact of social work-related
issues on length of stay in head and neck cancer patients and
emphasize the importance of starting the discharge process
early to prevent unnecessary prolonged length of stay.
Methods: A retrospective study of 100 patients scheduled
for head and neck surgeries identified using operative
schedule of a single head and neck surgeon was performed.
Included in the study were the patients who stayed longer

than 24 hours. Data collected/analyzed included total length
of stay, total hospitalized days until medically clear, and
total hospitalized days because of social work issues after
medically cleared (tube feed supply, tracheostomy care supply, rehabilitation placement, visiting nurse availability,
waiting for family to pick up, tube feed or tracheostomy
care teaching, patient preference, optional inpatient cancer
workup).
Results: Average length of stay was 10.8 days, and 19 of
100 patients stayed longer than medically necessary, with a
total of 67 days to resolve social issues. Overall, 5 of
29 patients who had medical complications during their hospitalization stayed longer than necessary because of nonmedical issues. Reasons for delayed discharge were rehabilitation
placement (n = 11), insurance approval (n = 4), visiting nurse
timing (n = 2), awaiting supplies (n = 1), and awaiting tube
feed teaching (n = 1).
Conclusions: Our study demonstrated that a large percentage
of head and neck patients (19%) stayed longer than medically
necessary with the most common reasons being awaiting
rehabilitation placement and insurance approval. We recommend action from rehabilitation facilities and insurance providers to reduce patients' unnecessary length of stay and the
cost to the health care system.
Minor Changes Leading to Major Effects:
Improving Readability in Patient Education
Peter Eskander (Presenter); Brette C. Harding, MD;
Laura M. Dooley, MD
Objectives: Patient education materials are vital to ensure
proper care after surgery for the best possible outcomes. A
sixth-grade reading level is the current national recommendation for education materials. Unfortunately, the reading level
of most education materials is much higher, resulting in patient
confusion of what is needed postoperatively to allow for the
best results from surgery.
Methods: This evaluative study assesses the readability of
postoperative patient education provided to otolaryngology
patients at the University of Missouri. Reading scores were
determined using https://readabilityformulas.com/, which
used several heavily scrutinized readability formulas to score
each document. Each document was then edited only once and
reevaluated using the same tool to determine the new reading
scores. Other information collected included total word count,
sentence length, and the number of words with 3 or more
syllables.
Results: The average reading level of patient education materials prior to any edits was 7.6. After edits, the average reading
level was 6.3. Sixteen of 26 total documents were successfully
edited to a sixth-grade or lower reading level after only one edit.
Of the documents that were edited to a sixth-grade or lower
level, the average number of words with 3 or more syllables
decreased from 26.7 to 20.9. However, the number of words per
sentence increased from 11.8 to 12.7, as well as the total word
count of each document from 248.8 to 274.8.

PSQI

Conclusions: By establishing a quality improvement and
monitoring program, we show that achieving a low incidence
of adverse events after thyroidectomy is possible. These data
can help inform practitioners and the public about expected
outcomes of thyroid surgery and establish benchmarks for
quality and safety.

P263


https://www.readabilityformulas.com/

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

Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts
Contents
Accreditation Information
2020 President Duane J. Taylor, MD
2020 Annual Meeting Program Committee
2020 Star Reviewers
2020 Distinguished Service Award Recipients
2020 Honor Award Recipients
Honorary Guest Lecturers 2020
Panel Presentations
Oral Presentations
Poster Presentations
Author Index
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Intro
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Cover2
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - A1
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - A2
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - A3
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Contents
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - A5
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - A6
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Accreditation Information
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - 2020 President Duane J. Taylor, MD
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - 2020 Annual Meeting Program Committee
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P4
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - 2020 Star Reviewers
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - 2020 Honor Award Recipients
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P7
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Honorary Guest Lecturers 2020
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P9
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Panel Presentations
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P11
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P12
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P13
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Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P41
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Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P45
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Oral Presentations
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P47
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P48
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P49
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Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Poster Presentations
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P152
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Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P277
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P278
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P279
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P280
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P281
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P282
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P283
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P284
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P285
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P286
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P287
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P288
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P289
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P290
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P291
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P292
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P293
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P294
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P295
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P296
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P297
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P298
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P299
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P300
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P301
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P302
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P303
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P304
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P305
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P306
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P307
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P308
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P309
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P310
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P311
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P312
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Author Index
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P316
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P317
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P318
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P319
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P320
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P321
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P322
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P323
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P324
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P325
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P326
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P327
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P328
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P329
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P330
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P331
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P332
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Cover3
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Cover4
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