Assessment of acute otitis externa and otitis media with effusion performance measures in otolaryngology practices.

OBJECTIVE: To evaluate the acute otitis externa and otitis media with effusion performance measure sets in a clinical setting and provide preliminary data on measure compliance. STUDY DESIGN AND SETTING: Quality improvement study. SUBJECTS AND METHODS: Convenience sampling (N = 84) was performed at five sites of ENT and Allergy Associates, LLC. RESULTS: Physicians reported prescribing topical antibiotic preparations and assessing for auricular or periauricular pain in 98% of acute otitis externa cases (N = 55). In addition, 87% did not prescribe systemic antimicrobials. Pneumatic otoscopy was used by 76% of physicians as a method for otitis media with effusion diagnosis and 10% administered a hearing test within 6 months before tympanostomy tube placement (N = 29). Furthermore, as recommended, 86% did not prescribe decongestants or antihistamines whereas 93% and 90% did not prescribe antimicrobials or systemic steroids, respectively. CONCLUSION: Although compliance in this study was generally high across both measure sets, actual use of the face sheet forms for appropriate patients was lower than the 80% reporting mandate by the Centers for Medicare and Medicaid Services that allows physicians to receive the monetary bonus. Incentive-based reporting should be continuously investigated to assess challenges for evaluating current measures.

Duke Scholars

Author David Latham Witsell Head and Neck Surgery & Communication Sciences