The Golden 24 Hours: Checklist Bundle Improves Quality of Acute Care for Patients with Decompensated Cirrhosis and Reduces 30-Day Mortality

Thiagarajan, Prarthana; Peal, CA; Gunn, Dixon; James, Matthew T.

doi:10.1016/s0168-8278(16)00338-x

Cited by 2 publications

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“…We hope that this will help reduce the variation in management and outcomes across the country. Other hospitals are now routinely using this bundle and have demonstrated similar improvements, which is encouraging . The main ‘frustration’ is that despite improving the early delivery of currently available treatments for decompensated cirrhosis, the mortality rate is still significant, which is in part due to the limited number of treatments available for some complications, such as acute on chronic liver failure and alcoholic hepatitis.…”

Section: Clinical Features Of Patients In the Three Groups Studiedmentioning

confidence: 95%

Editorial: improving in‐hospital management of decompensated cirrhosis by a ‘care bundle’ – hope, frustration and lessons to learn. Authors’ reply

McPherson

Dyson

Hudson

2017

Aliment Pharmacol Ther

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Newcastle. However, this statement ignores that the P value was of 0.4413, which statistically denies the existence of any trend. So, we are left with a (small) hope and with a (relatively big) frustration. The hope is demonstration that some quality parameters related to management of patients with decompensated cirrhosis can be improved by providing a care bundle, although the relevance of improving some indirect indicators remains conjectural. The frustration comes from seeing that despite the effort done, implementing a dedicated policy reinforcing early delivery of evidence-based care did not improve hard end-points. The lesson for the future is that probably we ought to select better the centres where we need to intervene, concentrating the effort where performance indicators, such as in-hospital mortality, are unusually high.

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Section: Clinical Features Of Patients In the Three Groups Studiedmentioning

confidence: 95%

Editorial: improving in‐hospital management of decompensated cirrhosis by a ‘care bundle’ – hope, frustration and lessons to learn. Authors’ reply

McPherson

Dyson

Hudson

2017

Aliment Pharmacol Ther

View full text Add to dashboard Cite

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Decompensated cirrhosis: targeted training of acute medical teams to improve quality of care in first 24 hours

et al. 2022

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Background: A quality improvement project in a secondary care centre was initiated to investigate and evaluate the impact of staff education and the use of the British Society of Gastroenterology/British Association for the Study of the Liver cirrhosis care bundle in improving care of patients admitted to hospital with decompensated liver cirrhosis. Method: A staff training programme was implemented, involving around 30 health professionals consisting of consultants, junior doctors, physician associates and nurses from the acute medical unit. A review of electronic documentation and analysis of key clinical parameters, pre- and post-intervention, was carried out. Results: The data show that the intervention has led to an improvement in patient management and clinical outcomes. Conclusion: This project illustrates that collaboration between hepatology and medical teams, with emphasis on education and training, benefits patients who present to hospital with decompensated liver cirrhosis.

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The Golden 24 Hours: Checklist Bundle Improves Quality of Acute Care for Patients with Decompensated Cirrhosis and Reduces 30-Day Mortality

Cited by 2 publications

References 0 publications

Editorial: improving in‐hospital management of decompensated cirrhosis by a ‘care bundle’ – hope, frustration and lessons to learn. Authors’ reply

Editorial: improving in‐hospital management of decompensated cirrhosis by a ‘care bundle’ – hope, frustration and lessons to learn. Authors’ reply

Decompensated cirrhosis: targeted training of acute medical teams to improve quality of care in first 24 hours

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