{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T13:05:39Z","timestamp":1790687139641,"version":"4.1.0"},"reference-count":5,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>National pediatric otolaryngology practice patterns can highlight high\u2010yield opportunities for quality improvement. Our objective was to identify procedures with the greatest potential impact for targeted quality initiatives using the ACS National Surgical Quality Improvement Program\u2010Pediatric (NSQIP\u2010P). Using the 2021\u20132023 NSQIP\u2010P Participant Use Files, we identified all Current Procedural Terminology (CPT Codes) submitted under otolaryngology and pediatric otolaryngology with more than five annual cases. Procedures were grouped by type, and a Pareto analysis was used to determine high\u2010volume targets. Across 2021\u20132023, 52,490 cases representing 91 CPT codes met inclusion criteria. Seven procedures accounted for 80% of case volume, including tympanoplasty with or without mastoidectomy (22.1%), airway endoscopy (19.1%), cochlear implantation (10%), endoscopic sinus surgery (10%), congenital neck cyst resection (8.8%), and palatoplasty (6.5%). Pediatric otolaryngology practice is highly concentrated in a small number of procedures. Focusing quality improvement efforts on these high\u2010volume surgeries may yield the greatest impact on reducing variation and optimizing outcomes.<\/jats:p>","DOI":"10.1002\/ohn.70471","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:49:59Z","timestamp":1790686199000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Using NSQIP\u2010P to Identify Areas of Greatest Opportunity for Quality Improvement in Pediatric Otolaryngology"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0489-4995","authenticated-orcid":false,"given":"Alexandra E.","family":"Hunter","sequence":"first","affiliation":[{"name":"Duke University School of Medicine Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3129-1133","authenticated-orcid":false,"given":"Tanner J.","family":"Zachem","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7243-288X","authenticated-orcid":false,"given":"Jeffrey","family":"Cheng","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine Durham North Carolina USA"},{"name":"Department of Head and Neck Surgery &amp; Communication Sciences Duke University School of Medicine Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"issue":"11","key":"e_1_2_5_2_1","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1001\/jamaoto.2014.2067","article-title":"Identification of opportunities for quality improvement and outcome measurement in pediatric otolaryngology","volume":"140","author":"Shah RK","year":"2014","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"issue":"1","key":"e_1_2_5_3_1","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1002\/lary.28538","article-title":"Patient safety and quality improvement in otolaryngology\u2013head and neck surgery: a systematic review","volume":"131","author":"Gettelfinger JD","year":"2021","journal-title":"Laryngoscope"},{"issue":"2","key":"e_1_2_5_4_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.sempedsurg.2023.151275","article-title":"The past, present and future of ACS NSQIP\u2010Pediatric: evolution from a quality registry to a comparative quality performance platform","volume":"32","author":"Saito JM","year":"2023","journal-title":"Semin Pediatr Surg"},{"issue":"1","key":"e_1_2_5_5_1","first-page":"1","article-title":"Clinical practice guideline: tympanostomy tubes in children (update)","volume":"166","author":"Rosenfeld RM","year":"2022","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"2","key":"e_1_2_5_6_1","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1177\/0194599818807917","article-title":"Clinical practice guideline: tonsillectomy in children (update)\u2010executive summary","volume":"160","author":"Mitchell RB","year":"2019","journal-title":"Otolaryngol Head Neck Surg"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.70471","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ohn.70471","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.70471","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:50:01Z","timestamp":1790686201000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1002\/ohn.70471"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,29]]},"references-count":5,"alternative-id":["10.1002\/ohn.70471"],"URL":"https:\/\/doi.org\/10.1002\/ohn.70471","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,29]]},"assertion":[{"value":"2026-02-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ohn.70471"}}