Audit clinico sugli interventi di adenotonsillectomia in Regione Piemonte: un intervento multilivello

Abstract

Background: Despite the dissemination of national and international clinical and organizational guidelines, adenotonsillectomy is still subject to a significant variability both at local and regional levels. To address the criticalities related to the different phases leading to adenotonsillectomy, the Department of Health in Piedmont engaged a multi-disciplinary team to carry out an intervention to improve the quality of care. To address the issue, the working group started a regional clinical audit. - Objective: To describe the approach and the process that involved more than one hundred professionals in the management of adenotonsillectomy within the 12 Local Health Authorities of the Piedmont Region in the period 2017-2019 as well as to discuss their main results. - Materials, methods and results: The activities that led to the implementation of the whole audit process were carried out considering both the development of a suitable set of measures and the definition of the sampling procedure for the selection of the patients’ medical files to be analysed. The methodology involved several professionals along the territory. The team was engaged in sharing the audit methodology, defining the evaluation procedures and selecting relevant indicators. All measured values showed an overall improvement that in some cases matched the identified quality standards. - Conclusions: The present research shows that the use of the clinical audit on a regional scale is a favourable tool for professional communities to improve the quality of care and can be used as a valuable participatory educational tool.