Mohanad Nasreddine
Introduction
Otitis media with effusion (OME), or glue ear, is a leading cause of hearing impairment in children under 12. It involves fluid accumulation in the middle ear without acute infection and can negatively impact speech, language development, and educational outcomes.
Method
A retrospective audit was conducted over two six-month cycles. Data collected included referral indications, audiological findings, management plans, and follow-up intervals before and after surgery. The first cycle was assessed against pre–August 2023 guidelines. Following this, results informed targeted interventions. The second cycle evaluated practice against updated guidelines, with additional analysis of cost-effectiveness and clinical benefit within the local patient population.
Results
Cycle one revealed inconsistent intra-operative documentation and incomplete adherence to recommended peri-operative follow-up intervals. After implementing targeted improvements, cycle two showed enhanced documentation quality, increased rates of audiological assessment within six weeks prior to grommet insertion, and better compliance with post-operative audiology and ENT follow-up recommendations.
Conclusion
Initial findings demonstrated suboptimal documentation and adherence to observation guidelines, alongside evidence of antibiotic underprescribing. Introduction of standardized templates for OME consultations and operative notes improved compliance in the second cycle. A third audit cycle is ongoing to further evaluate adherence to updated guidance, expand sample size, and better assess clinical outcomes and cost-effectiveness of implemented changes in the West midlands patient demographic.
Authors
Mohanad Nasreddine, Mustaffa Junaid
Sandwell and West Birmingham Hospitals, Birmingham, United Kingdom