Journey to Top Performance: A Multipronged Quality Improvement Approach to Reducing Cardiac Surgery Mortality

Scheinerman, S. Jacob; Dlugacz, Yosef; Hartman, Alan R.; Moravick, Donna; Nelson, Karen L.; Scanlon, Kerri; Stier, Lori

doi:10.1016/s1553-7250(15)41009-8

Cited by 6 publications

(3 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Kurlansky et al (56) demonstrate that low volume centres and low volume surgeons can have good outcomes if they are compliant with evidence-based quality standards (56). It is recognised that quality improvement requires multi-factorial interventions such as appropriate feedback and education (57). It may be that high volume for individual surgeons or high volume hospitals may actually be a surrogate for quality interventions such as protocolisation of care pathways, however future research to confirm this is warranted.…”

Section: Discussionmentioning

confidence: 99%

Systematic review and a meta-analysis of hospital and surgeon volume/outcome relationships in colorectal cancer surgery

Huo

Phan

Liauw

2017

J. Gastrointest. Oncol.

129

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Systematic review and a meta-analysis of hospital and surgeon volume/outcome relationships in colorectal cancer surgery

Huo

Phan

Liauw

2017

J. Gastrointest. Oncol.

129

View full text Add to dashboard Cite

show abstract

“…Rapid-cycle improvement constructs have shown some benefit but have been limited by mixed outcomes, complicated interventions, and unclear replicability (Grady et al, 2018; McDonald et al, 2013). Further, many healthcare improvement efforts have described localized projects within a single specialty to implement a specific program (Kamal & Behal, 2019; MacLean et al, 2018; Mittal et al, 2018; Scheinerman et al, 2015; Valsangkar et al, 2017). Few studies have described the efforts and results of large healthcare systems to improve patient care in a standardized manner across multiple clinical contexts (Lee et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Clinical Redesign: An Innovative Approach to Leading Change at an Academic Healthcare System

Li¹,

Davis²,

Kim³

et al. 2022

Journal of Healthcare Management

View full text Add to dashboard Cite

SUMMARY Goal: We characterized the core elements of a clinical redesign program (CRDP) to represent both a team and a methodology to rapidly improve outcomes important to patients and hospitals (e.g., length of stay, unnecessary care, and cost). Unique features of our CRDP included a clinician lead, engagement from senior leadership, formal project management, and rapid cycle implementation. We aimed to examine the effectiveness of this strategy across three different project examples. Methods: Using an observational pre–post study design, we compared the patient-level data for three representative projects applying the core elements of the CRDP: (1) optimizing telemetry utilization, (2) creating a high flow nasal cannula protocol in the pediatric intensive care unit, and (3) standardizing care for patients with chronic obstructive pulmonary disease and pneumonia. Principal Findings: The primary metrics for all three projects were a project-specific clinical outcome and cost per case. Telemetry utilization was reduced from a peak of 26.0% to 19.6% with a $1,075 reduction in cost per case. Creation of a high flow nasal cannula protocol led to a decrease in median pediatric intensive care unit length of stay from 77.3 to 75.8 hours with a $2,020 decrease in cost per case. Decreasing variation of care for patients with chronic obstructive pulmonary disease and pneumonia diagnoses led to a $371 decrease in cost per case. Applications to Practice: The CRDP adds to existing clinical quality improvement models using a structured process for a 90-day rapid cycle project turnaround. In addition, the CRDP incorporates project management and defined team members for the completion and sustainability of projects. The CRDP also facilitates the scalable translation of projects from local to systemwide and incorporates tracking of clinical and financial outcomes through interval internal auditing. These elements provide prioritization, resource allocation, and expertise for improved patient care and high-value care delivery. The CRDP can be adapted for other contexts to lead and foster momentum and drive rapid and successful completion of clinical improvement projects.

show abstract

“…1 The associated morbidity and mortality remain relatively high despite advances in surgical technique and anesthetic management. [1][2][3] One of the principal goals in the perioperative care of the cardiac surgery patient is to maintain end-organ perfusion and tissue oxygenation. With this aim in mind, it has been common practice to provide supraphysiologic levels of oxygen to patients while on CPB to protect against the risks of cellular hypoxia inherent in the un-physiologic nature of surgery and CPB.…”

mentioning

confidence: 99%

The impact of hyperoxia on outcomes after cardiac surgery: a systematic review and narrative synthesis

Heinrichs

Lodewyks

Neilson

et al. 2018

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

show abstract

Journey to Top Performance: A Multipronged Quality Improvement Approach to Reducing Cardiac Surgery Mortality

Cited by 6 publications

References 12 publications

Systematic review and a meta-analysis of hospital and surgeon volume/outcome relationships in colorectal cancer surgery

Systematic review and a meta-analysis of hospital and surgeon volume/outcome relationships in colorectal cancer surgery

Clinical Redesign: An Innovative Approach to Leading Change at an Academic Healthcare System

The impact of hyperoxia on outcomes after cardiac surgery: a systematic review and narrative synthesis

Contact Info

Product

Resources

About