ArticleCureus2025
Sustained Improvement in Paediatric ENT Emergency Referral Accuracy Through a Multimodal Educational Strategy: A Longitudinal Study.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Profile of Otorhinolaryngology-Related Emergency Department Visits and Revisits in a Tertiary Care Center in Riyadh, Saudi Arabia.Healthcare (Basel, Switzerland) · 2026Article
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe ENT emergency clinics often rely on SHO (Senior House Officer) level clinicians, such as Foundation Doctors and Core Trainees, to triage and assess urgent referrals. Emergency clinics receive urgent referrals for both adult and paediatric patients. Inconsistent adherence to locally available referral guidelines, which indicate what is appropriate for emergency clinic booking and what is not, can lead to inappropriate clinic utilisation, resulting in inefficiency and suboptimal patient care. This study aimed to evaluate guideline adherence in paediatric-only referrals to an SHO-led ENT emergency clinic in a tertiary centre and determine whether simple, low-cost interventions could improve and sustain compliance.
methodsThis study was a six-cycle Quality Improvement (QI) project. All paediatric patients seen in an SHO-led ENT emergency clinic between December 2020 and November 2022 at Queen's Medical Centre, Nottingham, UK, were analysed. A total of 209 encounters were reviewed using the Trust's electronic record system. Referral reasons were compared with the local Trust paediatric ENT emergency clinic referral guidelines. The PDSA (Plan Do Study Act) framework for QI was applied, and following the baseline audit, interventions included targeted junior doctor teaching, dissemination of referral criteria via online communication platforms, and a poster campaign in key clinical areas.
resultsBaseline adherence was 38.5% compared with a benchmark standard of 100% adherence. Following educational and communication-based interventions, the proportion of guideline-compliant referrals increased to 74.0%. This improvement achieved statistical significance and was sustained across subsequent audit cycles despite frequent SHO turnover. Staff demonstrated the strongest adherence in referrals for foreign bodies and epistaxis. Common inappropriate referrals included cerumen impaction and a discharging ear.
conclusionsSimple and sustainable interventions, including structured teaching, digital dissemination, and poster-based prompts, significantly improved guideline adherence in an SHO-led paediatric ENT emergency clinic. This low-cost QI model is easily reproducible in similar healthcare settings.
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