title: Indications for tonsillectomy: are we documenting them?
abstract: BACKGROUND
  Tonsillectomy is one of the most frequently performed operations in the UK. Documentation of the indications for tonsillectomy is vital, and should fulfil evidence-based guidelines where possible. We present a completed audit, evaluating the documentation of our department's practice in meeting the recommendations made by the Scottish Intercollegiate Guideline Network (SIGN) on indications for tonsillectomy.
  
  
  METHODS
  A prospective audit of 100 children undergoing tonsillectomy for recurrent tonsillitis at a university hospital during two time periods: October 2007 to January 2008 and March to September 2008. Interventions including the production of posters and rubber stamps were agreed and implemented between the two audit periods.
  
  
  RESULTS
  Following the implementation of simple changes, significant improvements were seen in documentation relating to the SIGN guidelines for tonsillectomy. Overall, the number of children meeting all four SIGN criteria for tonsillectomy rose from 12% to 44% (chi(2) = 57.8; P < 0.001). Furthermore, a significant reduction was seen in the number of children below the age of 5 years undergoing tonsillectomy for recurrent tonsillitis (chi(2) = 14.66; P < 0.001).
  
  
  CONCLUSIONS
  With increasing scrutiny on tonsillectomy, it is important to ensure that the reasons for performing tonsillectomy are documented clearly and adhere to evidence-based guidance where possible. We have demonstrated that, with only simple and low-cost interventions, significant improvements in the documentation of tonsillectomy indications can be achieved.
authors.affiliation: Department of Otolaryngology, City General Hospital, University Hospital North Staffordshire NHS Trust, Newcastle Road, Stoke-on-Trent ST4 7LN, UK. alextoh@doctors.org.uk
authors.forename: Alex
authors.initials: A
authors.lastname: Toh
authors.forename: Annemarie
authors.initials: A
authors.lastname: Mullin
authors.forename: Joe
authors.initials: J
authors.lastname: Grainger
authors.forename: Harpreet
authors.initials: H
authors.lastname: Uppal
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004282:Documentation / Q000592:standards; D019983:Guideline Adherence / Q000592:standards*; D006801:Humans; D008485:Medical Audit; D018579:Patient Selection; D012008:Recurrence; D014068:Tonsillectomy / Q000592:standards / Q000706:statistics & numerical data*; D014069:Tonsillitis / Q000601:surgery*; D006113:United Kingdom