
ENT surgeries encompass a wide range of procedures, from tympanostomy and adenoidectomy to tonsillectomy and thyroidectomy. The duration of these surgeries can vary significantly based on the complexity of the procedure and the patient’s condition.
Getting Ear Tubes for your child? This vital guide explains the quick surgery process and offers expert tips for an amazing, easy recovery.
For instance, a tonsillectomy and adenoidectomy typically take around 40–53 minutes for experienced surgeons. The time can vary due to factors such as the patient’s overall health and the specific techniques used by the surgeon.
Hospitals like LivHospital are at the forefront of ENT surgery, leveraging global standards and innovative techniques to ensure excellence in patient safety and surgical efficacy.
Key Takeaways
- ENT surgeries vary in duration based on procedure type and patient complexity.
- Tonsillectomy and adenoidectomy average around 40–53 minutes.
- Surgeon experience and technique can influence surgery duration.
- Patient health is a significant factor in determining surgery time.
- Innovative hospitals like LivHospital lead in ENT surgical excellence.
Overview of ENT Surgery Duration Factors

The length of ENT surgeries can vary significantly based on several key factors. Understanding these factors is crucial for patients to have realistic expectations about their surgical experience.
Types of ENT Procedures and Their Complexity
ENT procedures range from simple to complex surgeries. The complexity of the procedure is a significant factor in determining the surgical time. For instance, procedures like ear tube surgery are generally quicker compared to more complex surgeries such as septoplasty, which can take between 30 to 90 minutes.
Some common ENT procedures include:
- Tonsillectomy
- Adenoidectomy
- Ear tube insertion
- Septoplasty
- Thyroidectomy
The complexity of these procedures can be influenced by factors such as the patient’s anatomy, the presence of any complications, and the surgeon’s experience.
|
Procedure |
Typical Duration |
Complexity Level |
|---|---|---|
|
Ear Tube Surgery |
15-30 minutes |
Low to Moderate |
|
Septoplasty |
30-90 minutes |
Moderate to High |
|
Tonsillectomy |
30-60 minutes |
Moderate |
Patient-Specific Variables Affecting Surgical Time
Patient-specific variables such as age, overall health, and the presence of any comorbidities can significantly impact the duration of ENT surgeries. For example, pediatric patients may require additional preparation and care, potentially extending the overall surgical time.
- Previous surgical history
- Anatomical variations
- Presence of infections or other complicating factors
Understanding these factors helps in planning and preparing for ENT surgeries, ensuring the best possible outcomes for patients.
Tonsillectomy Duration: What to Expect

The length of time a tonsillectomy takes can depend on several factors, including the patient’s age. Tonsillectomy, a surgical procedure to remove the tonsils, is commonly performed in both children and adults. Understanding the average duration of this surgery can help patients prepare for their operation and recovery.
Average Procedure Time for Adult Tonsillectomy
For adults, a tonsillectomy typically takes around 15 to 24 minutes on average. However, the total time spent in the operating room will be longer due to preparation and recovery from anesthesia. The procedure time can vary slightly based on the surgeon’s experience and the specific techniques used.
Key factors influencing adult tonsillectomy duration include:
- The surgeon’s level of experience
- The presence of any anatomical variations
- The specific surgical technique employed
Pediatric Tonsillectomy Timeframes
In children, the tonsillectomy procedure time is generally similar to that of adults, averaging around 15 to 24 minutes. However, pediatric patients often require additional preparation and may have different anesthesia requirements, which can affect the overall time spent in the surgical facility.
Considerations for pediatric tonsillectomy include:
- The child’s age and overall health
- The presence of any complicating conditions, such as sleep disorders
- The need for specialized pediatric care and equipment
By understanding these factors, patients and their families can better prepare for the tonsillectomy procedure and what to expect during the recovery process.
Adenoidectomy: Typical Surgery Duration
Understanding the typical duration of adenoidectomy surgeries is crucial for patients preparing for the operation. Adenoidectomy, a procedure to remove the adenoids, is often performed in children but can also be necessary for adults. The surgery duration can vary based on several factors, including whether it’s performed as a standalone procedure or in conjunction with other surgeries like tonsillectomy.
Procedure Time for Standalone Adenoidectomy
Adenoidectomy, when performed alone, typically has a shorter duration compared to when it’s combined with other procedures. On average, a standalone adenoidectomy takes around 11 to 17 minutes to complete. This timeframe can vary slightly based on the surgeon’s experience and the specific techniques used.
Duration of Combined Tonsillectomy and Adenoidectomy
When adenoidectomy is performed alongside tonsillectomy, the total surgery time naturally increases. The combined procedure, known as tonsillectomy and adenoidectomy (T&A), is common in pediatric patients. The average duration for this combined surgery is approximately 40 to 53 minutes. The increase in time is due to the additional steps required for the tonsillectomy portion of the procedure.
|
Procedure Type |
Average Duration (minutes) |
|---|---|
|
Standalone Adenoidectomy |
11-17 |
|
Combined Tonsillectomy and Adenoidectomy |
40-53 |
The duration of adenoidectomy surgeries, whether standalone or combined with tonsillectomy, is an important consideration for patients and healthcare providers. Understanding these timeframes can help in planning and preparing for the surgery and the subsequent recovery period.
Ear Tubes Surgery: Complete Timeline and Process
Understanding the timeline and process of ear tubes surgery can help patients prepare for the procedure. Ear tubes surgery, or tympanostomy tube insertion, is a common operation that helps alleviate ear problems by draining fluid from the middle ear.
Tympanostomy Tube Insertion Step-by-Step
The process of tympanostomy tube insertion involves several key steps. First, the patient is administered anesthesia to ensure comfort during the procedure. The surgeon then makes a small incision in the eardrum, followed by the insertion of the tympanostomy tube. This tube allows for ventilation of the middle ear and drainage of any fluid.
The step-by-step process is as follows:
- Administration of anesthesia
- Incision in the eardrum
- Insertion of the tympanostomy tube
This procedure is typically quick, with bilateral tympanostomy tube insertion taking around 7–11 minutes. The brevity of the surgery and the use of appropriate anesthesia help minimize discomfort and stress for the patient.
Bilateral vs. Unilateral Ear Tube Placement Times
The duration of ear tubes surgery can vary depending on whether the procedure is bilateral (both ears) or unilateral (one ear). Bilateral tympanostomy tube insertion, as mentioned, typically takes around 7–11 minutes. In contrast, unilateral ear tube placement is generally quicker, often taking less time since it involves only one ear.
Key differences between bilateral and unilateral placements include:
|
Procedure Type |
Typical Duration |
|---|---|
|
Bilateral Ear Tube Placement |
7–11 minutes |
|
Unilateral Ear Tube Placement |
Less than bilateral |
Understanding these differences can help patients and their families better prepare for the surgery and what to expect during the recovery process.
Thyroidectomy and Complex ENT Procedures
For patients undergoing thyroid surgery, understanding the duration and complexity of the procedure is crucial. Thyroidectomy, a surgery involving the removal of all or part of the thyroid gland, is a significant operation that requires careful planning.
Duration Expectations for Different Thyroid Surgeries
The duration of thyroidectomy can vary based on the complexity of the case. A total thyroidectomy, which involves removing the entire thyroid gland, typically takes longer than a partial thyroidectomy. On average, a thyroidectomy procedure can last anywhere from 60 to 120 minutes.
The complexity of the surgery can be influenced by factors such as the size of the thyroid gland, the presence of any nodules or cancer, and the patient’s overall health. Surgeons may also need to consider the patient’s anatomy and any potential complications that could arise during the procedure.
Multi-Stage and Extended ENT Interventions
Some ENT procedures, including certain thyroidectomies, may involve multi-stage interventions. These are complex cases where the surgery is performed in stages, either due to the complexity of the condition or to minimize risks.
|
Procedure Type |
Average Duration |
Complexity Level |
|---|---|---|
|
Total Thyroidectomy |
90-120 minutes |
High |
|
Partial Thyroidectomy |
60-90 minutes |
Moderate |
|
Thyroidectomy with Lymph Node Dissection |
120-180 minutes |
Very High |
Understanding these factors can help patients and healthcare providers plan for the surgery and manage expectations regarding the duration and recovery process.
Comparing Pediatric and Adult ENT Surgery Times
The duration of ENT procedures differs between children and adults, influenced by age-related considerations. Understanding these differences is crucial for managing patient expectations and optimizing surgical outcomes.
Age-Related Factors Influencing Procedure Duration
Several age-related factors contribute to the variation in ENT surgery times between pediatric and adult populations. These include anatomical differences, the complexity of the procedure, and the patient’s overall health.
Anatomical Considerations: Children’s smaller anatomical structures can make ENT procedures more challenging and time-consuming. In contrast, adults typically have larger and more developed structures, potentially simplifying certain aspects of the surgery.
Procedure Complexity: The complexity of ENT surgeries can vary between age groups. For instance, pediatric patients may require more delicate handling due to their smaller size and developing anatomy.
|
Factor |
Pediatric ENT Surgery |
Adult ENT Surgery |
|---|---|---|
|
Anatomical Size |
Smaller, more delicate |
Larger, more developed |
|
Procedure Complexity |
Often more complex due to smaller structures |
Generally less complex, but can be influenced by comorbidities |
|
Recovery Time |
Typically faster in children |
Can be longer due to comorbid conditions |
Special Considerations in Pediatric ENT Surgery
Pediatric ENT surgery requires special considerations due to the unique anatomical and physiological characteristics of children. One common procedure is the insertion of ear tubes, also known as tympanostomy tubes, which help to drain fluid from the ear and reduce the incidence of ear infections.
The tubes ears procedure is typically quicker in children than many other ENT surgeries, often taking less than 15 minutes per ear. However, the overall time can vary based on whether the procedure is unilateral or bilateral.
In conclusion, comparing pediatric and adult ENT surgery times highlights the importance of age-related factors in determining procedure duration. By understanding these differences, healthcare providers can better prepare patients and their families for the surgical process.
Pre-Operative Preparation Impact on Surgery Duration
Pre-operative preparation is a crucial step that significantly influences the overall duration of ENT surgeries. This phase involves various tests, evaluations, and preparations that ensure the patient is ready for the procedure.
The time required for pre-operative preparation can vary depending on the complexity of the surgery and the patient’s health status. It’s essential to understand the different components of this preparation to appreciate its impact on the overall surgery duration.
Required Testing and Evaluation Timeframes
Before undergoing ENT surgery, patients are required to undergo certain tests and evaluations. These may include blood tests, imaging studies (such as CT or MRI scans), and a thorough medical history review. The timeframe for these tests can range from a few days to several weeks, depending on the complexity of the required evaluations.
|
Test/Evaluation |
Typical Timeframe |
|---|---|
|
Blood Tests |
1-3 days |
|
Imaging Studies |
2-7 days |
|
Medical History Review |
1-2 days |
An ENT specialist says, “Thorough pre-operative evaluation is critical to identifying potential risks and ensuring a smooth surgical process.”
“The goal is to optimize the patient’s condition before surgery, which in turn can reduce the overall duration and improve outcomes.”
Day-of-Surgery Preparation Process
On the day of the surgery, patients are required to follow specific preparation instructions. This typically includes fasting for a certain period, usually 8-12 hours before the surgery, and arriving at the hospital or surgical center with sufficient time to complete any remaining preparations.
Key Steps on the Day of Surgery:
- Arrival and registration
- Final preparations, including changing into a surgical gown
- Administration of anesthesia
- Surgical procedure
The day-of-surgery preparation process is designed to ensure that everything is in place for a successful surgery. By understanding and following these steps, patients can help minimize delays and ensure that their surgery starts on time.
Effective pre-operative preparation is essential for the success of ENT surgeries. By understanding the timeframes involved and the steps required, patients can better prepare themselves for the process, ultimately contributing to a smoother and more efficient surgical experience.
Anesthesia Protocols in ENT Surgeries
Anesthesia plays a crucial role in ENT procedures, impacting both the surgery’s success and the patient’s recovery. The type of anesthesia used can vary significantly depending on the specific ENT procedure, the patient’s overall health, and the surgeon’s preferences.
Types of Anesthesia and Administration Time
ENT surgeries may utilize different types of anesthesia, including local, general, or a combination of both. Local anesthesia numbs a specific area, allowing the patient to remain awake during the procedure. This type is often used for less complex ENT surgeries. General anesthesia, on the other hand, induces a state of unconsciousness, making it suitable for more complex or invasive procedures.
The administration time for anesthesia can vary. For local anesthesia, the process is typically quick, often taking just a few minutes. General anesthesia requires more time for induction and preparation, usually around 10 to 30 minutes, depending on the patient’s health and the complexity of the procedure.
Anesthesia Recovery Following ENT Procedures
Recovery from anesthesia is a critical phase of the ENT surgery process. For patients who received local anesthesia, the recovery is usually swift, with most patients able to go home shortly after the procedure. General anesthesia requires a longer recovery period, as the patient needs time to fully regain consciousness and for the anesthetic effects to wear off.
The recovery process is closely monitored by medical staff to ensure patient safety and comfort. Factors influencing recovery time include the type of anesthesia used, the patient’s overall health, and the specific ENT procedure performed.
Recovery Timelines After ENT Surgeries
After undergoing ENT surgery, patients often wonder about the recovery time and what to expect during the healing process. The recovery timeline following ENT surgeries can vary significantly depending on the type of procedure performed.
Immediate Post-Operative Recovery Periods
The immediate recovery period after ENT surgery typically involves a few days of rest and careful monitoring. Patients usually experience mild to moderate discomfort, which can be managed with pain medication prescribed by their doctor.
Key aspects of immediate post-operative care include:
- Resting and avoiding strenuous activities
- Following a soft food diet for certain procedures like tonsillectomy
- Monitoring for signs of complications, such as excessive bleeding or difficulty breathing
For instance, after a tonsillectomy, patients are advised to eat soft foods for a week or two to minimize discomfort and promote healing.
Long-Term Healing and Follow-Up Expectations
Long-term healing after ENT surgery can take several weeks to a few months. The exact duration depends on the complexity of the procedure and individual patient factors.
|
Procedure |
Immediate Recovery |
Long-Term Healing |
|---|---|---|
|
Tonsillectomy |
1-3 days |
1-2 weeks |
|
Adenoidectomy |
1-2 days |
1 week |
|
Ear Tubes Surgery |
Same day |
1-3 days |
As noted by an ENT specialist, “The key to a successful recovery is following the post-operative instructions provided by your healthcare provider and attending all scheduled follow-up appointments.”
“Recovery after ENT surgery requires patience and adherence to post-operative instructions. By understanding what to expect, patients can navigate their recovery more smoothly.” -ENT Specialist
Understanding the recovery timelines and adhering to post-operative care instructions are crucial for a successful outcome after ENT surgery.
Tympanostomy Tubes for Adults: Procedure Duration and Considerations
Tympanostomy tubes, commonly known as ear tubes, are a surgical solution for adults experiencing persistent ear fluid or recurring ear infections. This procedure involves the insertion of small tubes into the eardrum to drain fluid and ventilate the middle ear.
Adult vs. Pediatric Ear Tubes Procedure Differences
While tympanostomy tube insertion is more common in children, adults can also benefit from this procedure. The key differences between adult and pediatric ear tubes procedures lie in the anatomical considerations and the complexity of the surgery.
- Anatomical differences: Adult ear anatomy can be more complex, potentially making the procedure slightly more challenging.
- Anesthesia: Adults typically receive local anesthesia with sedation, whereas children often require general anesthesia.
- Procedure time: The surgery time can vary, but it’s generally quicker in adults due to less complexity.
Recovery and Effectiveness Timeframes
Understanding the recovery process and the effectiveness timeframe is crucial for adults considering tympanostomy tubes. The recovery is typically swift, with most adults resuming normal activities within a day or two.
- Immediate recovery: Patients may experience some discomfort or drainage, which usually subsides within a few days.
- Tube functionality: The tubes begin to function immediately, improving ventilation and reducing fluid buildup in the middle ear.
- Long-term effectiveness: The effectiveness of tympanostomy tubes can last until they naturally extrude, usually within 6 to 18 months.
In conclusion, tympanostomy tubes offer a viable solution for adults dealing with certain ear conditions. By understanding the procedure, differences from pediatric care, and what to expect during recovery, adults can make informed decisions about their ear health.
How to Drain Fluid from Ear: Surgical vs. Non-Surgical Approaches
The accumulation of fluid in the ear can be a bothersome condition, and there are multiple ways to drain it, including non-surgical and surgical options. Fluid buildup in the ear, also known as otitis media with effusion, can cause discomfort, hearing loss, and a feeling of fullness in the ear. Understanding the available methods for draining this fluid is crucial for effective management and relief.
Non-Surgical Fluid Drainage Methods and Duration
Non-surgical approaches are typically the first line of treatment for draining fluid from the ear. These methods are often preferred due to their less invasive nature and quicker recovery times.
- Nasal Decongestants: Using nasal decongestants can help alleviate nasal congestion, which in turn can help drain the Eustachian tube and relieve ear pressure.
- Ear Drops: Certain ear drops can help dry out the ear canal and potentially aid in fluid drainage.
- Valsalva Maneuver: This technique involves pinching the nose shut, closing the mouth, and gently blowing air through the nose to open the Eustachian tube, facilitating drainage.
- Toynbee Maneuver: Similar to the Valsalva maneuver, the Toynbee maneuver involves swallowing while pinching the nose shut to help open the Eustachian tube.
These non-surgical methods can vary in effectiveness and duration. For instance, nasal decongestants may provide relief within a few days, while the Valsalva and Toynbee maneuvers can offer immediate, though sometimes temporary, relief.
When Surgical Intervention Becomes Necessary
In cases where non-surgical methods fail to provide adequate relief, or if the fluid buildup is persistent and causing significant issues, surgical intervention may be necessary. Surgical options include:
- Myringotomy: A surgical procedure where a small incision is made in the eardrum to drain the fluid.
- Tympanostomy Tubes: Small tubes inserted into the eardrum to allow for drainage and ventilation of the middle ear.
Surgical intervention is typically considered when the condition persists or is severe. The decision to proceed with surgery is made on a case-by-case basis, taking into account the individual’s overall health, the severity of symptoms, and the effectiveness of previous treatments.
In conclusion, draining fluid from the ear can be achieved through various methods, ranging from non-surgical techniques to surgical interventions. Understanding these options and their durations can help individuals make informed decisions about their care.
Innovative ENT Centers: Advancements Reducing Surgery Time
Advancements in medical technology and surgical techniques are being pioneered by innovative ENT centers, reducing surgery times and improving patient outcomes. These centers are at the forefront of adopting cutting-edge techniques that enhance surgical efficiency and effectiveness.
The integration of advanced technologies and methodologies in ENT surgery has led to significant improvements in patient care. Focusing on quality has yielded new milestones in ENT safety and outcomes excellence, as seen in various innovative centers.
Cutting-Edge Techniques in Modern ENT Surgery
Modern ENT surgery has seen the introduction of various cutting-edge techniques that have streamlined surgical processes. These include:
- Minimally invasive surgical procedures
- Advanced imaging technologies for precise diagnostics
- Robot-assisted surgeries for enhanced precision
These techniques not only reduce the duration of surgeries but also contribute to faster recovery times and improved patient outcomes.
Technology Improving Surgical Efficiency and Outcomes
The role of technology in enhancing surgical efficiency and outcomes cannot be overstated. Innovative ENT centers are leveraging technologies such as:
- 3D printing for creating precise models of patient anatomy
- Advanced navigation systems for complex surgeries
- Telemedicine for pre- and post-operative care
These technological advancements are crucial in improving the overall quality of care and reducing the time required for surgical interventions.
Quality Protocols and Patient Safety in ENT Procedures
In the realm of ENT procedures, patient safety is intricately linked with adherence to stringent quality protocols. Ensuring the highest standards of care is not just a regulatory requirement but a moral imperative for healthcare providers.
ENT surgeries, like any other medical interventions, carry inherent risks. However, the implementation of internationally recognized standards and quality protocols significantly mitigates these risks. Internationally Recognized Standards in ENT Surgery are designed to ensure consistency and excellence in care delivery.
Internationally Recognized Standards in ENT Surgery
Organizations such as the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) and the Joint Commission play pivotal roles in establishing these standards. They provide guidelines on pre-operative, operative, and post-operative care, ensuring that ENT procedures are performed with the utmost regard for patient safety.
For instance, the AAO-HNS has developed numerous clinical practice guidelines that cover a range of ENT conditions and treatments. These guidelines are based on the latest evidence and are regularly updated to reflect advancements in medical science.
Measuring and Minimizing Complication Rates
One of the critical aspects of quality protocols in ENT surgery is the measurement and minimization of complication rates. Complication rates serve as a key performance indicator for healthcare facilities, reflecting their adherence to safety standards and quality of care.
To minimize complications, ENT centers employ various strategies, including:
- Regular training and credentialing of surgical staff
- Implementation of checklists and timeout procedures during surgeries
- Enhanced patient monitoring during the post-operative period
- Continuous quality improvement initiatives based on outcomes data
As emphasized by a study published in a leading medical journal, “Adherence to quality protocols and safety standards is crucial in reducing morbidity and mortality associated with ENT surgeries.” This underscores the importance of maintaining high-quality care in ENT procedures.
“The safety and quality of care provided to patients undergoing ENT procedures are directly related to the adherence to established protocols and guidelines.”
By prioritizing quality protocols and patient safety, ENT surgical centers can ensure the best possible outcomes for their patients. This not only enhances patient trust but also contributes to the overall advancement of ENT care.
Conclusion: Preparing for Your ENT Surgery
As you prepare for your ENT surgery, understanding the procedure and its associated timelines is crucial. The duration of ENT surgeries varies widely depending on the type of procedure, patient-specific factors, and the complexity of the intervention.
To ensure a smooth and successful surgical experience, it’s essential to follow pre-operative instructions carefully and arrange for post-operative care. This includes understanding the anesthesia protocols, recovery timelines, and any specific requirements for your procedure.
By being informed and prepared, you can minimize potential complications and optimize your recovery. If you’re scheduled to undergo an ENT surgery, consult with your healthcare provider to discuss your specific needs and any concerns you may have, thereby ensuring you’re well-preparing for ENT surgery.
FAQ
How long does a typical ENT surgery take?
The duration of ENT surgeries varies depending on the type of procedure, complexity, and patient-specific factors. On average, procedures like tonsillectomy can take around 30-60 minutes, while more complex surgeries like thyroidectomy may take longer, typically between 1-3 hours.
What factors influence the duration of ENT surgeries?
Factors such as the type of ENT procedure, patient age, health status, and complexity of the surgery can impact the duration. For example, pediatric ENT surgeries may be shorter due to the smaller anatomy, while complex procedures like septoplasty may require more time.
How long does a tonsillectomy procedure take for adults?
Adult tonsillectomy procedures typically take around 30-60 minutes to complete, depending on the complexity of the case and the surgeon’s experience.
What is the average duration of ear tubes surgery?
Ear tubes surgery, also known as tympanostomy tube insertion, is a relatively quick procedure that can take around 15-30 minutes per ear. Bilateral ear tube placements may take around 30-45 minutes.
How long does it take to recover from ENT surgery?
Recovery times vary depending on the type of ENT surgery. For example, patients may take around 1-2 weeks to recover from a tonsillectomy, while ear tubes surgery typically has a shorter recovery time of a few days.
Are there any differences in ENT surgery duration between pediatric and adult populations?
Yes, pediatric ENT surgeries are often shorter due to the smaller anatomy, while adult surgeries may be longer due to more complex anatomy or underlying health conditions.
What are the benefits of tympanostomy tubes for adults?
Tympanostomy tubes for adults can provide relief from chronic ear infections, hearing loss, and other complications. The procedure is relatively quick, and recovery times are typically short.
How do I prepare for ENT surgery?
To prepare for ENT surgery, patients should follow their surgeon’s instructions, complete any required testing and evaluation, and arrive at the hospital or surgical center on time. Patients should also arrange for post-operative care and follow-up appointments.
What are the risks and complications associated with ENT surgeries?
As with any surgery, ENT procedures carry risks and complications, such as bleeding, infection, or reaction to anesthesia. However, these risks can be minimized by following proper protocols and guidelines, and by choosing an experienced surgeon.
How can I drain fluid from my ear without surgery?
Non-surgical methods to drain fluid from the ear include using ear drops, nasal decongestants, or applying a warm compress. However, if the fluid persists or is accompanied by other symptoms, surgical intervention may be necessary.
What are the latest advancements in ENT surgery?
Innovative ENT centers are using cutting-edge techniques and technologies, such as endoscopic surgery, laser surgery, and robotic-assisted surgery, to improve surgical efficiency and outcomes.
What are the internationally recognized standards for ENT surgery?
Internationally recognized standards for ENT surgery include guidelines for patient safety, infection control, and surgical protocols. These standards help minimize complication rates and ensure high-quality care.
Reference
National Center for Biotechnology Information. Evidence-Based Medical Insight. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC4469133/