Gettelfinger John D, Paulk P Barrett, Schmalbach Cecelia E
1 Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA.
2 University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA.
Otolaryngol Head Neck Surg. 2017 Jun;156(6):991-998. doi: 10.1177/0194599817701112. Epub 2017 Apr 25.
Objective The breadth and depth of patient safety/quality improvement (PS/QI) research dedicated to otolaryngology-head and neck surgery (OHNS) education remains unknown. This systematic review aims to define this scope and to identify knowledge gaps as well as potential areas of future study to improved PS/QI education and training in OHNS. Data Sources A computerized Ovid/Medline database search was conducted (January 1, 1965, to May 15, 2015). Similar computerized searches were conducted using Cochrane Database, PubMed, and Google Scholar. Review Methods The study protocol was developed a priori using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Articles were classified by year, subspecialty, Institute of Medicine (IOM) Crossing the Chasm categories, and World Health Organization (WHO) subclass. Results Computerized searches yielded 8743 eligible articles, 267 (3.4%) of which met otolaryngology PS/QI inclusion criteria; 51 (19%) were dedicated to resident/fellow education and training. Simulation studies (39%) and performance/competency evaluation (23.5%) were the most common focus. Most projects involved general otolaryngology (47%), rhinology (18%), and otology (16%). Classification by the IOM included effective care (45%), safety/effective care (41%), and effective and efficient care (7.8%). Most research fell into the WHO category of "identifying solutions" (61%). Conclusion Nineteen percent of OHNS PS/QI articles are dedicated to education, the majority of which are simulation and focus on effective care. Knowledges gaps for future research include facial plastics PS/QI and the WHO category of "studies translating evidence into safer care."
目的 致力于耳鼻咽喉头颈外科（OHNS）教育的患者安全/质量改进（PS/QI）研究的广度和深度尚不清楚。本系统评价旨在界定这一范围，识别知识空白以及未来研究的潜在领域，以改进OHNS中的PS/QI教育与培训。 数据来源 进行了计算机化的Ovid/Medline数据库检索（1965年1月1日至2015年5月15日）。使用Cochrane数据库、PubMed和谷歌学术进行了类似的计算机化检索。 综述方法 使用系统评价和Meta分析的首选报告项目（PRISMA）预先制定研究方案。文章按年份、亚专业、医学研究所（IOM）跨越鸿沟类别和世界卫生组织（WHO）子类进行分类。 结果 计算机化检索产生了8743篇符合条件的文章，其中267篇（3.4%）符合耳鼻咽喉PS/QI纳入标准；51篇（19%）致力于住院医师/专科培训医师的教育与培训。模拟研究（39%）和绩效/能力评估（23.5%）是最常见的重点。大多数项目涉及普通耳鼻咽喉科（47%）、鼻科学（18%）和耳科学（16%）。IOM的分类包括有效护理（45%）、安全/有效护理（41%）和有效且高效护理（7.8%）。大多数研究属于WHO的“识别解决方案”类别（61%）。 结论 OHNS的PS/QI文章中有19%致力于教育，其中大部分是模拟研究且侧重于有效护理。未来研究的知识空白包括面部整形PS/QI以及WHO类别中的 “将证据转化为更安全护理的研究”。
