Can an advanced audiology‐led service reduce waiting times for paediatric ear nose and throat outpatient services?

Abstract

Aim Children with middle ear disease often experience lengthy delays waiting for outpatient paediatric ear nose and throat (ENT) services. This study aimed to investigate whether an alternative service delivery model using audiologists working in an expanded scope of practice reduced waiting times for children to access such services. Methods A total of 131 children consecutively referred to a large ENT outpatient service in Queensland, Australia, for middle ear and hearing concerns were prospectively allocated to either a standard ENT service or an advanced audiology (AA)‐led service. Waiting times and attendance rates were collected and compared between the two patient groups. Results The median waiting time from referral to first offered appointment was 96 days for children in the AA‐led service versus 417.5 days for children in the standard ENT service. Seventy‐nine percent of children in the AA‐led service attended their first offered appointment versus 61% in the standard ENT service. For children receiving grommets, the median waiting time from initial referral to grommet insertion was 226 days for children in the AA‐led service versus 627 days for children in the standard ENT service. Conclusion The AA‐led service was an effective alternative pathway to reduce waiting times for children referred to ENT services with middle ear and hearing concerns.

The reliability of video otoscopy recordings and still images in the asynchronous diagnosis of middle-ear disease

“…This increased the ability to see more children at the ENT clinic and improved its capacity by 77%. Waiting times for ventilation tubes insertion as a surgical treatment for otitis media was significantly reduced through this independent advanced audiology service (Pokorny et al, 2021). In addition to being effective, the service was found to be safe in discharging children not requiring treatment, referring those who need surgical intervention to ENT specialists, and reviewing children post-ventilation tubes insertion (Pokorny et al, 2020).…”

How can scope of practice be described and conceptualised in medical and health professions? A systematic review for scoping and content analysis

“…In comparison, advanced practice initiatives nearly all described allied health or nursing/midwifery task delegations for medicine, as opposed to the natural progression of a discipline‐specific, full SOP. Specific examples referenced included: pharmacist‐administered vaccination 152 ; audiology‐led triage in paediatric and adult otolaryngology patients 106,153,154 ; nurse‐led emergency department triage and care 72,155–159 and administration of procedural sedation 160 ; midwife‐led frenotomy 161 ; and primary practitioner physiotherapist services for musculoskeletal patients 39,41,45,54,99,105,154,162–166 . An exception to this trend was several studies focused on enrolled nurses assuming task delegations, most usually medication endorsement, for registered nurses as a progression of their discipline scope 135,136,167–170 …”

“…pharmacist-administered vaccination 152 ; audiology-led triage in paediatric and adult otolaryngology patients 106,153,154 ;…”

Cost Analysis of Orthoptist-Led Neurofibromatosis Type 1 Screening Clinics

“…Spending 20 minutes less at the clinic with a clinician is likely to be welcomed by patients and their families (Ballantyne et al 2019). Shorter appointment times without compromising the quality of care encourages families to accept future allied health-led clinic appointments (Pokorny et al 2021). As the orthoptist-led NF1 clinic appointments are scheduled on the same day as the patient's neurology appointment, costs, and time associated with hospital appointments for the patient and family are reduced.…”