The use of standardized order sets to improve adherence to evidence-based postoperative management in major head and neck surgery

European Annals of Otorhinolaryngology, Head and Neck Diseases
S AnsariL J Sowerby

Abstract

Standardized order sets (SOSs) are clinical tools derived from clinical care pathways that have shown improved patient-recovery and economic benefits. The primary objective was to examine the effect of SOSs on adherence to evidence-based postoperative guidelines for laryngectomy patients. A retrospective chart review comparing handwritten and SOS-based postoperative physician orders was conducted for consecutive laryngectomies performed (n=70) within a 3-year time period. Orders were analyzed for errors and deviations from evidence-based guidelines. Secondary outcome included complications such as thromboembolic disease, return to operating room, fistula formation, salivary bypass tube, length of hospital stay and death. Approximately 81% of cases utilizing handwritten orders had at least one error (n=36) compared to 38% in the group that used an SOS (n=34) (P<0.0001). Subgroup analyses demonstrated that errors in mechanical deep vein thrombosis prophylaxis (P<0.0001) and antibiotic prophylaxis (P=0.0173) orders were significantly reduced in the SOS group compared to the handwritten group. No significant differences were observed between the two groups for measured postoperative complications (P>0.05) and length of hospital sta...Continue Reading

Citations

Sep 25, 2020·Plastic and Reconstructive Surgery·Angela S VolkLarry H Hollier
Dec 31, 2020·Anesthesiology·Ellen M SoffinStavros G Memtsoudis

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