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Πέμπτη 17 Φεβρουαρίου 2022

Running a paediatric ambulatory sleep service in a pandemic and beyond

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Abstract

OBJECTIVES

In response COVID-19, re-establishing safe elective services was prioritised in the UK. We assess the impact on face-to-face hospital attendance, cost, and efficiency of implementing a virtual sleep clinic (intervention 1) to screen for children requiring level 3 ambulatory sleep studies using newly implemented ENT-UK guidelines for obstructive sleep apnoea (OSA) investigation (intervention 2). Objectives: (1) compare the proportion of children attending sleep clinic undertaking a sleep study before and after implementation of these interventions; (2) compare clinic cancellations and first-time success rates of sleep studies before and after intervention.

DESIGN

Retrospective analysis.

SETTING

District general hospital paediatric sleep clinic.

PARTICIPANTS

Children aged 3 months to 16 years referred to sleep clinic by ENT for investigation of OSA over the 3-months immediately following interventions (1 June 2020 – 1 September 2020) to the same period in the previous year (1 June 2019 – 1 September 2019).

MAIN OUTCOME MEASURES

Number of children attending sleep clinic; date of birth / age of children attending sleep clinic; of number of children undergoing sleep study; diagnostic outcomes; number of appointment cancellations; number of first-time sleep study failures.

RESULTS

Post-intervention, there was a significant reduction in the proportion of children undertaking ambulatory sleep studies, and non-significant reductions in appointment cancellations and in first-time sleep study failures.

CONCLUSIONS

The introduction of the virtual sleep clinic meant that only those children requiring a sleep study attended a face-to-face appointment, which led to reduced face-to-face attendance. There were also unintended cost-effectiveness and efficiency benefits, with potential longer-term learning implications for the wider sleep community and other diagnostic services.

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