Abstract
Introduction
Polysomnography (PSG) testing is expensive and not easily accessible. Waiting time for a routine PSG at the Alberta Children’s Hospital (ACH) can be up to a year. Majority of PSG studies performed are for diagnosis of obstructive sleep apnea (OSA). A previous quality improvement (QI) project conducted at the ACH showed that two-thirds of children who had undergone initial PSG testing had an apnea hypopnea index (AHI) in the normal or mild range. Given our limited resources, better characterization of patient referral characteristics and process factors as documented on the PSG requisition will inform our triage process, decrease wait time, improve resource allocation and information provided to referral sources.
Methods
Retrospective review of PSG’s performed for the initial diagnosis of OSA was completed between January 2018 and March 2020 at the ACH. Patient referral characteristics (age, sex, growth parameters, medical diagnosis, indication for PSG, previous airway surgery), process factors (source of referral, PSG referral and completion date, triage status) and AHI were recorded. Patients were divided into two groups (group A: normal and mild; group B: moderate and severe) based on AHI. Data obtained from the groupings were compared and analyzed descriptively. PSG triage to completion time was also calculated for each group.
Results
A total of 798 initial PSG studies were completed between January 2018 and March 2020. Of the PSG’s reviewed 64.8% were in group A and 35.2% were in group B. Common medical diagnoses in group A included ADHD, Asthma and Autism, whereas group B had T21 and Enuresis. History of previous airway surgery did not differ between groups.
Conclusion
Further clarification of the patient’s underlying medical diagnosis (referral characteristic) may help inform our triage process. The implication of previous airway surgery (process factor) on AHI severity is unclear at this point. More data is actively being collected to further interrogate these preliminary findings.
Support (if any):
Analyses of Described Situation of Patient Referral Documents and Their Compliance with the Designated FormFocusing on Preparation Means, Number of Characters, and Scale for Medical Facilities