Sustained Improvement in the Performance of Rapid Sequence Intubation Five Years after a Quality Improvement Initiative
| Autor: | Matthew R. Mittiga, Srikant B. Iyer, Karen Ahaus, Kartik Varadarajan, Andrea S. Rinderknecht, Mary Frey, Benjamin T. Kerrey, Stephanie Boyd, Joseph W. Luria, Gary L. Geis |
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| Rok vydání: | 2021 |
| Předmět: | |
| Zdroj: | Pediatric Quality & Safety |
| ISSN: | 2472-0054 |
| Popis: | Supplemental Digital Content is available in the text. Introduction: Many quality improvement interventions do not lead to sustained improvement, and the sustainability of healthcare interventions remains understudied. We conducted a time-series analysis to determine whether improvements in the safety of rapid sequence intubation (RSI) in our academic pediatric emergency department were sustained 5 years after a quality improvement initiative. Methods: There were 3 study periods: baseline (April 2009–March 2010), improvement (July 2012–December 2013), and operational (January 2014–December 2018). All patients undergoing RSI were eligible. We collected data using a structured video review. We compared key processes and outcomes with statistical process control charts. Results: We collected data for 615 of 643 (96%) patient encounters with RSI performed: 114 baseline (12 months), 105 improvement (18 months), and 396 operational (60 months). Key characteristics were similar, including patient age. Statistical process control charts indicated sustained improvement of all 6 key processes and the primary outcome measure (oxyhemoglobin desaturation) throughout the 5-year operational period. Conclusions: Improvements in RSI safety were sustained 5 years after a successful improvement initiative, with further improvement seen in several key processes. Further research is needed to elucidate the factors contributing to sustainability. |
| Databáze: | OpenAIRE |
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