A Systematic Review of Quality Improvement Interventions in Burn Care

Abstract

Background Quality improvement interventions (QII) are intended to improve the care of patients. Unlike most traditional clinical research, these endeavours emphasize sustainable implementation of scientific evidence rather than establishment of evidence. Our purpose was to conduct a systematic review of QII publications in the field of burn care. Methods A systematic review was conducted utilising electronic databases (Medline, Embase, Cochrane Library) of all studies relating to ‘quality improvement’ in burn care published until 31 March 2020. Studies were excluded if no baseline data was reported, or if no intervention was applied and tested. Studies were scored using a novel ten-point evaluation system for QII. Results We evaluated 414 studies involving ‘quality improvement’ in burn care. Only 82 studies contained a QII while 332 studies were categorised as traditional research. Several traditional research studies made claims to be quality improvement interventions, but few met the criteria. Of the 82 QII references, only 20 (24%) were accessible as full text manuscripts, the remainder were published as abstracts only. The mean score was 7.95 for full text studies (range 6-10) and 7.4 for abstract-only studies (range 5.5-9.5). Conclusions Despite the importance of quality improvement (QI) in burn care, very few studies have been published that employ true QI methodology, and many QII studies never advance beyond publication as abstracts in conference proceedings. Based on this systematic review, we propose guidelines to improve the quality of QII submissions.