Accelerating surgical quality improvement in Ontario through a regional collaborative: a quality-improvement study.

Autor: Jackson, Timothy, Schramm, David, Moloo, Husein, Fairclough, Lee, Maeda, Azusa, Beath, Tricia, Nathens, Avery
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Zdroj: CMAJ Open; 7/3/2018, Vol. 6 Issue 3, pE353-E359, 7p, 3 Charts, 1 Graph, 1 Map
Abstrakt: Background: The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) collaborative in Ontario, the Ontario Surgical Quality Improvement Network (ON-SQIN), was launched in January 2015. We describe its approaches to support surgical quality improvement and examine its early impact on member hospitals. Methods: All Ontario hospitals that participated in the ON-SQIN and NSQIP were included in this quality-improvement study. The primary intervention was the introduction of the ON-SQIN, and the secondary interventions included a community of practice and access to quality-improvement resources and tools. Outcome measures included the level of quality-improvement capacity, collaborative-wide aggregate data on postoperative complications, and self-reported rates of surgical site and urinary tract infections. Results: Eighteen hospitals that enrolled in the ON-SQIN in 2015 reported an increase in their capacity for quality improvement after 18 months. Analysis of the collaborative-wide aggregate data in a 6-month period (14 748 surgical cases) revealed a substantial reduction of acute renal failure (relative risk 0.48, 95% confidence interval 0.25-0.95) and urinary tract infection (relative risk 0.77, 95% confidence interval 0.61-0.97). Most hospitals that targeted prevention of surgical site infection and urinary tract infection reported reduction of these occurrences during a 1-year period. Interpretation: The ON-SQIN supported the uptake of the NSQIP in Ontario hospitals and promoted targeted surgical qualityimprovement initiatives, resulting in increased quality-improvement capacity and development of the community of practice. Furthermore, our early experience suggests that improvements in surgical care are being realized. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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