The Experts below are selected from a list of 777 Experts worldwide ranked by ideXlab platform

Paul Hong - One of the best experts on this subject based on the ideXlab platform.

  • perceptions and observations of shared decision making during Pediatric Otolaryngology surgical consultations
    Journal of Otolaryngology-head & Neck Surgery, 2019
    Co-Authors: Yolanda Evong, Jill Chorney, Paul Hong, Gilanders Ungar
    Abstract:

    Increased parental involvement in the decision-making process when considering elective surgeries for their children, termed shared decision-making (SDM), may lead to positive outcomes. The objective of this study was to describe perceived and observed levels of SDM during Pediatric Otolaryngology consultations. One hundred and seventeen parents and their children undergoing elective surgical consultations were prospectively enrolled. The visits were videotaped and coded using the Observing Patient Involvement (OPTION) scale. Following the encounter, all participants completed a questionnaire that measured perceived levels of SDM (SDM-Q-9). Surgeons also completed a similar questionnaire (SDM-Q-Doc). Spearman’s correlation coefficient was determined to measure the associations between observed and perceived levels of SDM. The overall OPTION scores were low (median score of 14 out of 48) and not significantly correlated with perceived levels of SDM (SDM-Q-9, p = 0.415; SDM-Q-Doc, p = 0.236), surgery type (p = 0.197), or patient demographic factors. The OPTION scores were positively correlated with consultation length (p < 0.001). There was great variability in the level to which each OPTION items were observed during the consultation (not present in any visits to present in 96.6% of the visits). Observed levels of SDM were consistently low, but higher levels were observed when the surgeon spent more time during the consultation. Observed levels of SDM did not match perceived levels of SDM, which were consistently rated higher by both caregivers and surgeons.

  • shared decision making during surgical consultations an observational study in Pediatric Otolaryngology
    European Annals of Otorhinolaryngology Head and Neck Diseases, 2019
    Co-Authors: J Melong, Jeremy D. Meier, Paul Hong
    Abstract:

    Abstract Aims Shared decision-making (SDM) is a collaborative process in which patients and family members make healthcare decisions together with their clinician. The objective of this study was to explore how Pediatric otolaryngologists involve parents in SDM and which factors influence this process. Material and methods Ninety-six children being assessed by Pediatric otolaryngologists at a tertiary healthcare center for elective surgical procedures (adeno/tonsillectomy or tympanostomy tube insertion) were prospectively enrolled into the study. Surgical consultations were video-recorded and coded using the OPTION instrument to determine level of SDM. To provide a subjective measure of SDM, parents completed the Shared Decision-Making Questionnaire (SDM-Q-9) and surgeons completed the physician version of the questionnaire (SDM-Q-Doc). Results Total mean child and parents OPTION scores were 3.16 (SD: 5.43, range: 0–21) and 11.38 (SD: 6.41, range: 1–27) out of 48 respectively. Clinicians were more likely to involve female children in SDM as well as children who had a previous history of surgery. There were no other significant correlations between total OPTION scores and patient/family demographics. A positive correlation was found between length of consultation and total OPTION scores for parents, but not for children. SDM-Q-9 and SDM-Q-Doc scores were not correlated with total OPTION scores. Conclusion Decision making during Pediatric Otolaryngology consultations mostly focused on treatment related decisions and sharing information as opposed to facilitating collaborative decision-making. Parent and physician perceptions of SDM were not correlated with actual observed behavior. Additional research is required to provide insight in how to increase surgeons’ assistance towards SDM.

  • shared decision making in Pediatric Otolaryngology parent physician and observational perspectives
    International Journal of Pediatric Otorhinolaryngology, 2016
    Co-Authors: Ayala Y Gorodzinsky, Paul Hong, Krista C. Ritchie, Janet Curran, Erin Maguire, Jill Chorney
    Abstract:

    Abstract Objective To describe physician and parent behavior during Pediatric Otolaryngology surgical consultations, and to assess whether perceptions of shared decision-making and observed behavior are related. Methods Parents of 126 children less than 6-years of age who underwent consultation for adeontonsillectomy or tympanostomy tube insertion were prospectively enrolled. Parents completed the Shared Decision-Making Questionnaire-Patient version (SDM-Q-9), while surgeons completed the Shared Decision-Making Questionnaire-Physician version (SDM-Q-Doc) after the consultation. Visits were video-recorded and analyzed using the Roter Interaction Analysis System to quantify physician and parent involvement during the consultation. Results Perceptions of shared decision-making between parents (SDM-Q-9) and physicians (SDM-Q-Doc) were significantly positively correlated (p = 0.03). However, there was no correlation between parents' perceptions of shared decision-making and observations of physician and parent behavior/involvement (proportion of physician socioemotional talk, task-focused talk, or proportion of parent talk). Surgeons' perceptions of shared decision-making were correlated with physician task-focused talk and proportion of parent talk. Conclusions Parents and physicians had similar perceptions of the degree of shared decision-making to be taking place during Pediatric Otolaryngology consultations. However, there was variability in the degree to which parents participated, and parent perceptions of shared decision-making were not correlated with actual observed involvement.

  • informed consent in Pediatric Otolaryngology what risks and benefits do parents recall
    Otolaryngology-Head and Neck Surgery, 2016
    Co-Authors: Kiersten Pianosi, Ayala Y Gorodzinsky, Jill Chorney, Gerard Corsten, Liane B Johnson, Paul Hong
    Abstract:

    ObjectiveTo evaluate parental recall of surgical risks and benefits in Pediatric Otolaryngology and to assess for factors that may influence recall.Study DesignProspective cohort study.SettingAcademic Pediatric Otolaryngology clinic.Subjects and MethodsEighty-four parents of children <6 years of age who underwent consultation for adeno/tonsillectomy and/or tympanostomy tube insertion were prospectively enrolled. Consultation visits were video recorded and the benefits and risks of surgery documented. Two weeks following the consultation, parents were contacted for assessment of recall of information discussed during the consultation.ResultsOverall, parents recalled only one-third of the risks of surgery mentioned by the surgeons. Parents were significantly more likely to recall the benefits of surgery as opposed to the risks (P < .001). Nine parents (10.7%) reported that no benefits were discussed during the consultation, and 10 (11.9%) reported no mention of any risks. Inconsistencies were present in whi...

  • parental knowledge in Pediatric Otolaryngology surgical consultations a qualitative content analysis
    International Journal of Pediatric Otorhinolaryngology, 2015
    Co-Authors: Ayala Y Gorodzinsky, Jill Chorney, Paul Hong
    Abstract:

    Abstract Objective To understand the source of parents’ knowledge prior to and desire for further information following Pediatric Otolaryngology surgical consultations. Methods Mixed-methods approach using descriptive and qualitative content analysis of interviews with parents following Otolaryngology consultations for children under the age of 6 years was performed. The children were being seen for either tonsillitis, obstructive sleep apnea, otitis media, and/or sinusitis/nasal obstruction. Results Forty-one parents completed a phone interview two weeks following their child's surgical consultation. The majority of parents indicated that their primary care physician referred their child for either: investigation of symptoms (50%), to have a specific discussion about surgery (27.5%), or because other treatment options were no longer working (20%). Many parents (56.5%) indicated that the Internet was their primary source of information prior to the appointment. Most parents (93%) wanted more information; majority of these parents noted that a technology-based mode of delivery of information available prior to the appointment would be most desirable. Desired information was most often regarding the surgical procedure, including risks and benefits, and symptoms of concern prior to surgery. Conclusion This study provides a description of parental knowledge and information sources prior to their child's surgical consultation and continued desire for information. This information may lead to decreased knowledge barriers and increased communication to facilitate shared decision-making between the provider and parents.

Emily F Boss - One of the best experts on this subject based on the ideXlab platform.

  • parental health literacy in Pediatric Otolaryngology a pilot study
    International Journal of Pediatric Otorhinolaryngology, 2019
    Co-Authors: Nicole L Aaronson, Courtney Cox, Emily F Boss
    Abstract:

    Abstract Objectives Pediatric Otolaryngology bears the highest frequency of elective surgical cases in children, but little is known regarding the health literacy of these children's parents. In a questionnaire-based pilot study, we assessed parental health literacy in our Pediatric Otolaryngology clinic and evaluated its relation to personal demographics. We also evaluated postoperative and diagnosis-based leaflets for readability using validated measures. Methods Parents completed the Short Assessment of Health Literacy-English (SAHL-E) and were defined as low (0–14) or high (>14) literacy based on mean scores. Results Fifty parents participated (mean SAHL-E score, 17.6), and all scored >14, indicating proficient health literacy. No differences existed in mean or median scores based on demographics. Continued education after high school was associated with higher scores (P = 0.003) and was the only significant variable in multivariable linear regression. All leaflets were at or below the recommended reading level for public health information. Conclusions Parents generally had high health literacy.

  • health literacy in Pediatric Otolaryngology a scoping review
    International Journal of Pediatric Otorhinolaryngology, 2018
    Co-Authors: Nicole L Aaronson, Catherine L Joshua, Emily F Boss
    Abstract:

    Abstract Objective To review research on status and outcomes of health literacy in Pediatric Otolaryngology and identify opportunities for quality improvement. Methods We performed a scoping review, adhering to methodologic standards. A combination of MeSH terms and keywords related to health literacy in Otolaryngology was used to conduct a search. Relevant studies were identified using PubMed, Ovid MEDLINE, and Google Scholar databases. Studies were selected for inclusion by two authors if they addressed the domains of Pediatric Otolaryngology as well as health literacy. Data were abstracted from each study on the number of participants, the setting, the study design, the outcome measure, the intervention used, and the overall theme. Authors identified prominent overarching themes and grouped studies accordingly. Results were then tabulated for further review and to discern implications for future practice and research. Results Of 1046 articles identified, 20 articles were included. Studies fell into three major themes: readability of patient materials, patient recall after informed consent, and optimal patient education. Prominent findings included the following: 1. Much of the printed and electronic educational material in Otolaryngology is above the recommended reading level for public health information; 2. Parents do not easily recall information provided verbally or in written form; and 3. Adding visual and multimodal components improves the success of parental education. Conclusion Health literacy in Pediatric Otolaryngology may influence comprehension of educational materials and adequacy of informed consent. Future research may address whether patient health literacy affects clinical outcomes.

  • identification of opportunities for quality improvement and outcome measurement in Pediatric Otolaryngology
    Archives of Otolaryngology-head & Neck Surgery, 2014
    Co-Authors: Rahul K Shah, Emily F Boss, Anne M Stey, Kris R Jatana, Shawn J Rangel
    Abstract:

    Importance Despite increased emphasis on measuring safety outcomes and quality indicators for surgical care, little is known regarding which operative procedures should be prioritized for quality-improvement initiatives in Pediatric Otolaryngology. Objective To describe the 30-day adverse event rates and relative contributions to morbidity for procedures in Pediatric Otolaryngology surgery using data from the American College of Surgeons’ National Surgical Quality Improvement Program Pediatric database (ACS-NSQIP-P). Design, Setting, and Participants Analysis of records contained in the ACS-NSQIP-P 2011-2012 clinical database. The ACS-NSQIP-P is a nationwide risk-adjusted, clinical outcomes–based program aimed at measuring and improving Pediatric surgical care. Fifty hospitals participated in the 2011-2012 ACS-NSQIP-P program. Medical records of patients who underwent tracked otolaryngologic procedures were accrued in the ACS-NSQIP-P database. These were inclusive of specific otolaryngologic surgical procedures and do not represent the entire spectrum of Pediatric Otolaryngology surgical procedures. Main Outcomes and Measures Individual 30-day adverse events, composite morbidity, composite serious adverse events, and composite hospital-acquired infections were compiled. Clinically related procedure groups were used to broadly evaluate outcomes. Procedures and groups were evaluated according to their relative contribution to otolaryngologic morbidity and their incidence of major complications. Results A total of 8361 patients underwent 1 of 40 selected Otolaryngology procedures; 90% were elective; 76% were performed on an outpatient or ambulatory basis; and 46% were American Society of Anesthesiologists (ASA) class 2 cases. Individual 30-day adverse event rates were highest for return to the operating room (4%), surgical site infection (2%), pneumonia (1%), sepsis (1%), and reintubation (1%). The highest rates of composite morbidity were seen for tracheostomy in patients younger than 2 years (23%), airway reconstruction (19%), and tympanoplasty with mastoidectomy (2%). Airway reconstruction procedures had the highest rates of composite serious adverse events (16%), followed by tracheostomy (13%) and abscess drainage (5%). Tracheostomy (31%) and airway reconstruction (16%) made the largest relative contributions to composite morbidity rate of the procedures studied. Tracheostomy in patients younger than 2 years had the highest composite hospital-acquired infection rate (14%), followed by airway reconstruction procedures (11%) and tympanoplasty with mastoidectomy (2%). Conclusions and Relevance While the overall rate of major postoperative morbidity in Pediatric Otolaryngology is low, areas for targeted quality-improvement interventions include tracheostomy, airway reconstruction, mastoidectomy, and abscess drainage. Measurement of outcomes specific to otolaryngologic procedures will be necessary to further identify and measure the impact of quality-improvement initiatives in Pediatric Otolaryngology.

  • whose experience is measured a pilot study of patient satisfaction demographics in Pediatric Otolaryngology
    Laryngoscope, 2014
    Co-Authors: Carrie L Nieman, Stacey L Ishman, James R Benke, David F Smith, Emily F Boss
    Abstract:

    Objectives/Hypothesis Despite a national emphasis on patient-centered care and cultural competency, minority and low-income children continue to experience disparities in health care quality. Patient satisfaction scores are a core quality indicator. The objective of this study was to evaluate race and insurance-related disparities in parent participation with Pediatric Otolaryngology satisfaction surveys. Study Design Observational analysis of patient satisfaction survey respondents from a tertiary Pediatric Otolaryngology division. Methods Demographics of survey respondents (Press Ganey Medical Practice Survey©) between January and July 2012 were compared to a clinic comparison group using t test and chi-square analyses. Multivariate logistic regression analyses were performed to assess likelihood to complete a survey based on race or insurance status. Results A total of 130 survey respondents were compared to 1,251 patients in the comparison group. The mean patient age for which the parent survey was completed was 5.7 years (6.1 years for the comparison group, P = 0.18); 59.2% of children were ≤5 years old. Relative to the comparison group, survey respondents were more often white (77.7% vs. 58.1%; P <0.001) and privately insured (84.6% vs. 60.8%; P <0.001). Similarly, after controlling for confounding variables, parents of children who were white (OR 1.8, 95% CI 1.13–2.78, P = 0.013) or privately insured (OR 2.9, 95% CI 1.74–4.85, P <0.001) were most likely to complete a survey. Conclusion Methods to evaluate satisfaction did not capture the racial or socioeconomic patient distribution within this Pediatric division. These findings challenge the validity of applying patient satisfaction scores, as currently measured, to indicate health care quality. Future efforts to measure and improve patient experience should be inclusive of a culturally diverse population. Level of Evidence 2c. Laryngoscope, 124:290–294, 2014

  • patient experience in the Pediatric Otolaryngology clinic does the teaching setting influence parent satisfaction
    International Journal of Pediatric Otorhinolaryngology, 2013
    Co-Authors: Emily F Boss, Richard E Thompson
    Abstract:

    Abstract Objectives Patient experience scores are now recognized as a chief indicator of healthcare quality. This report compares outpatient Pediatric Otolaryngology patient satisfaction in the teaching and non-teaching settings. Study design Cross-sectional, multi-site, patient-level analysis of satisfaction surveys (Press Ganey™ Medical Practice©) completed by parents of Pediatric Otolaryngology patients in FY2010. Methods Surveys were stratified by teaching/non-teaching affiliation. The survey has 29 Likert-scaled questions which comprise an overall score and subscores in 6 domains: access , visit , nursing , provider , personal issues , and assessment . The item likelihood-to-recommend was measured to indicate practice loyalty. Mean scores were compared by Kruskal–Wallis rank test. Multivariate logistic regression was performed to evaluate the association of teaching status with receipt of highest scores (HI-SCORES). Results 4704 Pediatric surveys were analyzed, with 1984 (42%) from the teaching setting. For the teaching setting, mean scores were lower overall (88.1 vs. 89.0; p access (includes scheduling ease, promptness in returning calls; 86.7 vs. 89.4; p personal issues (includes office hour convenience, sensitivity to needs; 87.0 vs. 88.5; p p p  = 0.011) and for access (OR 0.8; 95%CI 0.67–0.95; p  = 0.012); probability of HI-SCORES was similar for the two settings for all other domains. Conclusions Parents of Pediatric Otolaryngology patients evaluated in the teaching setting report lower satisfaction related to access, but similar scores for care providers and practice loyalty. Academic Otolaryngology practices might focus on access issues to improve the overall care experience for children and families.

Jessica R Levi - One of the best experts on this subject based on the ideXlab platform.

  • factors contributing to missed appointments in a Pediatric Otolaryngology clinic
    Laryngoscope, 2021
    Co-Authors: Pratima Agarwal, Ajay S Nathan, Zaroug Jaleel, Jessica R Levi
    Abstract:

    OBJECTIVE To understand why Pediatric Otolaryngology patients do not attend scheduled clinic appointments and identify factors correlated with no-show status. STUDY DESIGN Retrospective cohort study. METHODS This is a retrospective cohort study that uses medical record data extraction of patients that was scheduled to attend new patient appointments at a Pediatric Otolaryngology clinic in 2018. RESULTS Factors associated with no-shows included complex psychiatric history (OR (95% CI) 0.789 (0.71-0.88), P < .001), increased appointment lead time (OR (95% CI) 0.981 (0.976-0.987), P < .001), afternoon appointments (OR (95% CI) 0.783 (0.64-0.99), P = .038), and complex maternal medical history (OR (95% CI) 0.987 (0.979-0.996), P < .005). In contrast, factors associated with attendance included complex patients' medical history (OR (95% CI) 1.058 (0.98-1.02), P < .001), primary care physician at the same hospital (OR (95% CI) 2.766 (2.25-3.39), P < .001), and primary language being Spanish (OR (95% CI) 2.536 (1.75-3.67) P < .001). The factors of distance from the hospital (OR (95% CI) 1.001 (0.99-1.01), P = .868), season of appointment (P = .997), race (P = .623), and ethnicity (P = .804) were not associated with attendance or no-shows. CONCLUSION Patient and maternal medical problems, mental health history, primary care location, appointment lead time, hour of appointment, and primary language, all contribute to appointment attendance, while appointment timing, race, and ethnicity are not associated with attendance. Further work must be performed to overcome these barriers to minimize healthcare risks and improve patient outcomes. QUALITY OF EVIDENCE Level 3 Laryngoscope, 2021.

  • parental views on the role of social media in Pediatric Otolaryngology
    Annals of Otology Rhinology and Laryngology, 2021
    Co-Authors: Libby M. Ward, Jessica R Levi, Chelsea A. Sykora, Yash Prakash, Michael B. Cohen
    Abstract:

    OBJECTIVE Social media is playing an increasingly important role in medicine as a tool for patients and their families to find information and connect with others. The goal of this study is to understand parental views on if and how social media should be incorporated into Pediatric Otolaryngology by physicians and hospitals. METHODS A survey was distributed to parents of Pediatric otolaryngologic patients to assess views on professional social media use by physicians and hospitals. The proportion of parents who answered with specific responses in the survey was computed using the SPSS frequency analysis function. RESULTS One hundred five parents completed the survey. Ninety-six percent of respondents use social media, of which 92% use social media at least once a day (n = 93). Eighty-five percent of respondents said they definitely or probably would visit their physician's professional social media page (n = 90). Seventy-four percent would be interested in obtaining more information about the physician (n = 76). Forty-one percent would be interested in patient stories (n = 76). Twenty-eight percent would visit out of curiosity (n = 76). Twenty-six percent would want to gather more information about the hospital (n = 76). Seventeen percent would want to connect with other patients and their family members (n = 76). Sixty-seven percent of respondents believe it is important for physicians to have a professional social media page, and 79% of respondents believe it is important for hospitals to have a public social media page (n = 93). CONCLUSION The vast majority of parents of Pediatric otolaryngologic patients use social media regularly and would want to gather information about their physician and hospital through social media. Therefore, physicians and hospitals should consider using social media as a valuable tool to connect with and relay information to patients and their family members.

  • sj-pdf-1-aor-10.1177_00034894211037413 – Supplemental material for Parental Views on the Role of Social Media in Pediatric Otolaryngology
    2021
    Co-Authors: Libby M. Ward, Chelsea A. Sykora, Yash Prakash, Michael B. Cohen, Jessica R Levi
    Abstract:

    Supplemental material, sj-pdf-1-aor-10.1177_00034894211037413 for Parental Views on the Role of Social Media in Pediatric Otolaryngology by Libby M. Ward, Chelsea A. Sykora, Yash Prakash, Michael B. Cohen and Jessica R. Levi in Annals of Otology, Rhinology & Laryngology

  • review of Pediatric Otolaryngology clinical trials past trends and future opportunities
    Laryngoscope, 2020
    Co-Authors: Kunal R Shetty, Sevan Komshian, Anand K Devaiah, Jessica R Levi
    Abstract:

    OBJECTIVES/HYPOTHESIS Pediatric otolaryngologic conditions are highly prevalent in the United States. Although data gathered from clinical trials drive therapeutic strategies, the trends of research in Pediatric Otolaryngology remain unclear. The objective of this study was to characterize recent trials in Pediatric Otolaryngology to better understand current directions of study and to identify opportunities for future research. STUDY DESIGN Retrospective analysis. METHODS A retrospective analysis of United States Pediatric clinical trials in Otolaryngology between 2001 and 2017 was conducted on ClinicalTrials.gov. Criteria for inclusion included otolaryngologic trials with at least one trial arm of participants <18 years of age, interventional design that was closed, and conducted in the United States. We assessed the information available to us on ClinicalTrials.gov to identify recent trends in Pediatric Otolaryngology interventional research. We used PubMed to examine publication rates and National Institutes of Health RePORTER to characterize funding patterns for these trials. RESULTS Of the 122 trials analyzed, 25% investigated treatments for rhinitis, 25% for acute otitis media, and 50% for all other conditions. Drug studies comprised 72% of all trials. Overall, 65% had their results published in a peer-reviewed journal. Industry funding accounted for 73% of financial support. CONCLUSIONS Continued focus on the development of Pediatric otolaryngologic clinical trials allows an opportunity to better represent the wide spectrum of disease and therapy in the specialty. Increasing the rates of results publication and federal funding may spearhead a more balanced landscape of clinical trials and further advance the care of children with otolaryngologic disease. LEVEL OF EVIDENCE NA Laryngoscope, 130:2719-2724, 2020.

  • physician impact on the patient and family experience in a Pediatric Otolaryngology practice
    Laryngoscope, 2019
    Co-Authors: Ryan P Camilon, Jessica R Levi, Rose A Carrion, Gary D Josephson
    Abstract:

    OBJECTIVE On the Press Ganey (PG) survey, the item "likelihood of recommending practice" is a proxy for patient satisfaction because only the most satisfied patients will recommend a practice to friends and family. The objective of this study is to determine which other items on the PG survey best correlate with "likelihood of recommending practice" as a measure of patient satisfaction in Pediatric Otolaryngology. STUDY DESIGN Retrospective analysis of a survey database. METHODS The PG survey, consisting of 24 questions scaled from 1 to 5 representing (1) very poor, (2) poor, (3) fair, (4) good, and (5) very good, was sent to 28 different Pediatric Otolaryngology practices. Using the Pearson correlation coefficient, the statistical relationship of each PG survey question was analyzed in its association to the PG question "likelihood of recommending practice." Factors with a correlation coefficient greater than 0.65 were considered significant. RESULTS Ten of 24 questions on the PG survey correlated with a top "likelihood of recommending practice" score. Eight of these 10 items were from the Care Provider category and were related to the physician-patient/family interaction. CONCLUSION Patient satisfaction surveys are utilized as a quality metric of the patient and family experience. These scores serve as one of several measures that affect reimbursement. The results demonstrate that most of the factors correlated with "likelihood of recommending practice" are provider-based. In conclusion, the physician-patient interaction strongly influences the potential for a practice to earn top box scores on the PG item "likelihood of recommending practice" and thereby achieve the highest patient satisfaction. LEVEL OF EVIDENCE NA. Laryngoscope, 129:2610-2613, 2019.

Diego Preciado - One of the best experts on this subject based on the ideXlab platform.

  • Pediatric Otolaryngology in the covid 19 era
    Otolaryngologic Clinics of North America, 2020
    Co-Authors: Steven E Sobol, Diego Preciado, Scott M Rickert
    Abstract:

    Although the majority of attention to the health care impact of COVID-19 has focused on adult first responders and critical care providers, the pandemic has had a profound effect on the entire health care industry, including the Pediatric Otolaryngology community. This article highlights the unique ramifications of COVID-19 on Pediatric Otolaryngology, with a focus on the immediate and potential long-term shifts in practice. Specifically, the article is divided into 3 sections (care for the patient, care for the practitioner, and care for the practice) and details the unique effects of the pandemic on the Pediatric Otolaryngology specialty.

  • trends in u s Pediatric Otolaryngology fellowship training
    Archives of Otolaryngology-head & Neck Surgery, 2015
    Co-Authors: Ali Espinel, Marian Poley, George H Zalzal, Kenny H Chan, Diego Preciado
    Abstract:

    Importance Interest in Pediatric Otolaryngology fellowship training is growing. The workforce implications of this growing interest are unclear and understudied. Objectives To analyze trends in Pediatric Otolaryngology training, determine where fellows who graduated over the past 10 years are currently practicing, and test the hypothesis that graduates from Accreditation Council for Graduate Medical Education (ACGME)–accredited programs were more likely to have academic tertiary positions with faculty appointments. Design, Setting, and Participants We conducted a web-based analysis of Pediatric Otolaryngology fellowship graduates. The names of all 274 applicants who were matched to Pediatric Otolaryngology fellowships from May 31, 2003, to May 31, 2014, were obtained from the SF Match website. Accreditation status of each program for each match year was obtained from the ACGME website. We then performed an Internet search for the current practice location of each matched applicant. Analysis was conducted from January 1, 2015, to May 1, 2015. Main Outcomes and Measures Practice setting per year of fellowship match and accreditation status of program. Results For the 2003 to the 2014 match years, there was an increase from 5 to 22 accredited Pediatric Otolaryngology fellowship programs overall; simultaneously, the number of yearly matched applicants increased from 14 to 35. More graduates with ACGME accreditation practice at academic settings compared with graduates without ACGME accreditation although the difference was not statistically significant (67.1% vs 50.7%; P  = .15). Graduates from accredited programs, however, were significantly more likely to practice at a hospital-based setting compared with those from nonaccredited programs (81.7% vs 65.5%; P  = .003). Fellows trained in the last 10 years are relatively well distributed across the country. Conclusions and Relevance The number of Pediatric Otolaryngology fellowship applicants as well as total number of matched applicants and ACGME-accredited positions has risen in the last 10 years. It appears that a higher proportion of fellows trained in accredited programs work in academic positions in hospital-based practices. The long-term effect on the Pediatric Otolaryngology workforce of training more fellows in accredited fellowships remains to be seen.

  • accreditation council for graduate medical education accreditation and influence on perceptions of Pediatric Otolaryngology fellowship training experience
    Archives of Otolaryngology-head & Neck Surgery, 2013
    Co-Authors: Joshua R Bedwell, Sukgi S Choi, Kenny H Chan, Diego Preciado
    Abstract:

    IMPORTANCE The American Society of Pediatric Otolaryngology (ASPO) has set a goal of universal accreditation of fellowship programs by the Accreditation Council for Graduate Medical Education (ACGME) by 2014. This study offers data comparing trainee experience at accredited vs nonaccredited programs. OBJECTIVE To evaluate perceptions of Pediatric Otolaryngology fellowship training experience and to elucidate differences between those who trained in ACGME-accredited fellowships vs those who did not. DESIGN AND PARTICIPANTS Web-based survey sent to all members of ASPO, as well as recent fellowship graduate ASPO-eligible physicians. Responses were obtained in an anonymous fashion. The study population comprised 136 ASPO members who recently graduated from Pediatric Otolaryngology fellowship programs (36 from ACGME-accredited fellowships and 100 from nonaccredited programs). MAIN OUTCOMES AND MEASURES Difference in perceived fellowship experience between graduates of accredited vs nonaccredited programs, specifically, differences in service vs education perceptions. RESULTS Overall, a majority (64%) of respondents agreed that standardizing the Pediatric fellowship curriculum through ACGME accreditation is a worthwhile goal. Those who attended ACGME-accredited fellowships were more likely to favor accreditation vs non-ACGME graduates (83% vs 58%; P = .006). Graduates of ACGME-accredited programs were also more likely to agree that their fellowship provided adequate preparation for a career in academic medicine (100% vs 89%; P = .04), protected time for research (94% vs 60%; P < .001), vacation and academic time (94% vs 78%; P = .03), and opportunities to formally evaluate their superiors (72% vs 32%; P < .001). Non-ACGME graduates reported higher primary call frequency (0.8 days per week vs 0.2 days per week; P = .01), and attending physician participation in rounds (71% vs 53%; P = .05). CONCLUSIONS AND RELEVANCE Most respondents were in agreement with universal ACGME accreditation. Those having trained in accredited programs cite increased allowance for research, academic and vacation time, more formal opportunities to evaluate their faculty, and decreased primary call burden.

  • the role of advanced practice providers in Pediatric Otolaryngology academic practices
    International Journal of Pediatric Otorhinolaryngology, 2013
    Co-Authors: Brian K Reilly, Diego Preciado, Gretchen Brandon, Rahul Shah, George Zalzal
    Abstract:

    Abstract Objective The goal of this study was to examine the roles of Physician Assistants (PAs) and Nurse Practitioners (NPs) in Pediatric academic Otolaryngology programs to provide a better understanding of their scope of practice, levels of autonomy, clinical duties, teaching opportunities and research participation. Design An anonymous web-based electronic survey tool was sent to all Pediatric Otolaryngology fellowship program directors in the United States. Results Nurse Practitioners and Physician Assistants are utilized in approximately 3 out of every 4 Pediatric Otolaryngology practices. The top three job activities of both the PA and NP were: (1) seeing patients independently, (2) working alongside doctors in clinic, and (3) answering phone lines/parental calls. A higher percentage of PAs (83%), worked alongside doctors in clinic, as compared to NPs, where only 55% work alongside MDs. Over half of PAs round with the in-patient team and see consults as compared to just over one third of NPs who participate in such activities. Twenty-five percent of practices reported that PAs cover call and assist in the OR. Most PAs/NPs saw between 11 and 15 patients per clinic which provides a clear productivity advantage when looking to screen patients, provide medical care, generate surgical cases, and maximize billings. Conclusion NPs and PAs have complimentary skill sets ideal for the Pediatric Otolaryngology workplace, although job activities and “best fit” are hospital and practice dependent. Our study suggests that the use of PAs and NPs will continue to grow to meet increased demand for services in the field of Pediatric Otolaryngology. Employing advanced practice providers enables academic centers to improve access, provide additional financial remuneration, reduce wait times for new patients, and allow attending physicians to meet increased practice demands.

  • Pediatric Otolaryngology in the united states demographics workforce perceptions and current practices
    Archives of Otolaryngology-head & Neck Surgery, 2009
    Co-Authors: Diego Preciado, David E Tunkel, George H Zalzal
    Abstract:

    Objectives To evaluate self-reported workforce needs and demands, professional activities, and the clinical practices of Pediatric otolaryngologists in the United States for the purpose of better understanding the Pediatric Otolaryngology workforce and predicting manpower needs. Design A Web-based survey was sent to all members of the American Society of Pediatric Otolaryngology (ASPO). It achieved a 39.3% response rate, with a total of 99 US member respondents. We compared this sample to the overall US ASPO membership to determine if our respondent cohort was representative of ASPO demographics. Participants All members of ASPO. Main Outcome Measures Responses were categorized by demographics and nature of respondent practice (academic vs private practice). Results Respondents were representative of the US ASPO membership. Most of the respondents practiced in an academic setting (n = 70; 70%). Academicians reported seeing a higher percentage of patients with Medicaid public insurance than did private practitioners (34% vs 25.0%) ( P  = .03). Academicians spent a greater portion of their time than private practitioners on research (14.4% vs 6.6% of time) ( P P  = .002). With the exception of choanal atresia repair, there were no differences in the types of airway, otologic, head and neck, and plastic and reconstructive surgery performed by the 2 groups. Although fewer than half of the respondents (47%; n = 44) believed that there presently is a shortage of Pediatric Otolaryngology manpower, most (68%; n = 63) ( P  = .01) believed that there would be a shortage in 5 years. Conclusions Pediatric otolaryngologists predict an increased demand for their services in the near future. The only differences in the clinical practices of academic and private Pediatric otolaryngologists are patient payer mix and the amount of time devoted to teaching.

Jill Chorney - One of the best experts on this subject based on the ideXlab platform.

  • perceptions and observations of shared decision making during Pediatric Otolaryngology surgical consultations
    Journal of Otolaryngology-head & Neck Surgery, 2019
    Co-Authors: Yolanda Evong, Jill Chorney, Paul Hong, Gilanders Ungar
    Abstract:

    Increased parental involvement in the decision-making process when considering elective surgeries for their children, termed shared decision-making (SDM), may lead to positive outcomes. The objective of this study was to describe perceived and observed levels of SDM during Pediatric Otolaryngology consultations. One hundred and seventeen parents and their children undergoing elective surgical consultations were prospectively enrolled. The visits were videotaped and coded using the Observing Patient Involvement (OPTION) scale. Following the encounter, all participants completed a questionnaire that measured perceived levels of SDM (SDM-Q-9). Surgeons also completed a similar questionnaire (SDM-Q-Doc). Spearman’s correlation coefficient was determined to measure the associations between observed and perceived levels of SDM. The overall OPTION scores were low (median score of 14 out of 48) and not significantly correlated with perceived levels of SDM (SDM-Q-9, p = 0.415; SDM-Q-Doc, p = 0.236), surgery type (p = 0.197), or patient demographic factors. The OPTION scores were positively correlated with consultation length (p < 0.001). There was great variability in the level to which each OPTION items were observed during the consultation (not present in any visits to present in 96.6% of the visits). Observed levels of SDM were consistently low, but higher levels were observed when the surgeon spent more time during the consultation. Observed levels of SDM did not match perceived levels of SDM, which were consistently rated higher by both caregivers and surgeons.

  • shared decision making in Pediatric Otolaryngology parent physician and observational perspectives
    International Journal of Pediatric Otorhinolaryngology, 2016
    Co-Authors: Ayala Y Gorodzinsky, Paul Hong, Krista C. Ritchie, Janet Curran, Erin Maguire, Jill Chorney
    Abstract:

    Abstract Objective To describe physician and parent behavior during Pediatric Otolaryngology surgical consultations, and to assess whether perceptions of shared decision-making and observed behavior are related. Methods Parents of 126 children less than 6-years of age who underwent consultation for adeontonsillectomy or tympanostomy tube insertion were prospectively enrolled. Parents completed the Shared Decision-Making Questionnaire-Patient version (SDM-Q-9), while surgeons completed the Shared Decision-Making Questionnaire-Physician version (SDM-Q-Doc) after the consultation. Visits were video-recorded and analyzed using the Roter Interaction Analysis System to quantify physician and parent involvement during the consultation. Results Perceptions of shared decision-making between parents (SDM-Q-9) and physicians (SDM-Q-Doc) were significantly positively correlated (p = 0.03). However, there was no correlation between parents' perceptions of shared decision-making and observations of physician and parent behavior/involvement (proportion of physician socioemotional talk, task-focused talk, or proportion of parent talk). Surgeons' perceptions of shared decision-making were correlated with physician task-focused talk and proportion of parent talk. Conclusions Parents and physicians had similar perceptions of the degree of shared decision-making to be taking place during Pediatric Otolaryngology consultations. However, there was variability in the degree to which parents participated, and parent perceptions of shared decision-making were not correlated with actual observed involvement.

  • informed consent in Pediatric Otolaryngology what risks and benefits do parents recall
    Otolaryngology-Head and Neck Surgery, 2016
    Co-Authors: Kiersten Pianosi, Ayala Y Gorodzinsky, Jill Chorney, Gerard Corsten, Liane B Johnson, Paul Hong
    Abstract:

    ObjectiveTo evaluate parental recall of surgical risks and benefits in Pediatric Otolaryngology and to assess for factors that may influence recall.Study DesignProspective cohort study.SettingAcademic Pediatric Otolaryngology clinic.Subjects and MethodsEighty-four parents of children <6 years of age who underwent consultation for adeno/tonsillectomy and/or tympanostomy tube insertion were prospectively enrolled. Consultation visits were video recorded and the benefits and risks of surgery documented. Two weeks following the consultation, parents were contacted for assessment of recall of information discussed during the consultation.ResultsOverall, parents recalled only one-third of the risks of surgery mentioned by the surgeons. Parents were significantly more likely to recall the benefits of surgery as opposed to the risks (P < .001). Nine parents (10.7%) reported that no benefits were discussed during the consultation, and 10 (11.9%) reported no mention of any risks. Inconsistencies were present in whi...

  • parental knowledge in Pediatric Otolaryngology surgical consultations a qualitative content analysis
    International Journal of Pediatric Otorhinolaryngology, 2015
    Co-Authors: Ayala Y Gorodzinsky, Jill Chorney, Paul Hong
    Abstract:

    Abstract Objective To understand the source of parents’ knowledge prior to and desire for further information following Pediatric Otolaryngology surgical consultations. Methods Mixed-methods approach using descriptive and qualitative content analysis of interviews with parents following Otolaryngology consultations for children under the age of 6 years was performed. The children were being seen for either tonsillitis, obstructive sleep apnea, otitis media, and/or sinusitis/nasal obstruction. Results Forty-one parents completed a phone interview two weeks following their child's surgical consultation. The majority of parents indicated that their primary care physician referred their child for either: investigation of symptoms (50%), to have a specific discussion about surgery (27.5%), or because other treatment options were no longer working (20%). Many parents (56.5%) indicated that the Internet was their primary source of information prior to the appointment. Most parents (93%) wanted more information; majority of these parents noted that a technology-based mode of delivery of information available prior to the appointment would be most desirable. Desired information was most often regarding the surgical procedure, including risks and benefits, and symptoms of concern prior to surgery. Conclusion This study provides a description of parental knowledge and information sources prior to their child's surgical consultation and continued desire for information. This information may lead to decreased knowledge barriers and increased communication to facilitate shared decision-making between the provider and parents.

  • Understanding shared decision making in Pediatric Otolaryngology
    Otolaryngology–Head and Neck Surgery, 2015
    Co-Authors: Jill Chorney, Rebecca Haworth, M. Elise Graham, Krista C. Ritchie, Janet Curran, Paul Hong
    Abstract:

    ObjectiveThe aim of this study was to describe the level of decisional conflict experienced by parents considering surgery for their children and to determine if decisional conflict and perceptions of shared decision making are related.Study designProspective cohort study.SettingAcademic Pediatric Otolaryngology clinic.Subjects and methodsSixty-five consecutive parents of children who underwent surgical consultation for elective otolaryngological procedures were prospectively enrolled. Participants completed the Shared Decision Making Questionnaire and the Decisional Conflict Scale. Surgeons completed the Shared Decision Making Questionnaire–Physician version.ResultsEleven participants (16.9%) scored over 25 on the Decisional Conflict Scale, a previously defined clinical cutoff indicating significant decisional conflict. Parent years of education and parent ratings of shared decision making were significantly correlated with decisional conflict (positively and negatively correlated, respectively). A logis...