Using a society database to evaluate a patient safety collaborative: the Cardiovascular Surgical Translational Study
Abstract
Aim: To assess the utility of using external databases for quality improvement (QI) evaluations in the context of an innovative QI collaborative aimed to reduce three infections and improve patient safety across the cardiac surgery service line. Methods: We compared changes in each outcome between 15 intervention hospitals (infection reduction protocols plus safety culture intervention) and 52 propensity score-matched hospitals (feedback only). Results: Improvement trends in several outcomes among the intervention hospitals were not statistically different from those in comparison hospitals. Conclusion: Using external databases such as those of professional societies may permit comparative effectiveness assessment by providing concurrent comparison groups, additional outcome measures and longer follow-up. This can better inform evaluation of continuous QI in healthcare organizations.
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References
Papers of special note have been highlighted as: • of interest; •• of considerable interest
1.
Shojania KG, Grimshaw JM. Evidence-based quality improvement: the state of the science. Health Affairs 24(1), 138–150 (2005).
2.
Grimshaw J, Eccles M, Thomas R et al. Toward evidence-based quality improvement. J. Gen. Intern. Med. 21(S2), S14–S20 (2006).
3.
Shortell SM, Bennett CL, Byck GR. Assessing the impact of continuous quality improvement on clinical practice: what it will take to accelerate progress. Milbank Q. 76(4), 593–624 (1998).
4.
Eccles M, Grimshaw J, Campbell M, Ramsay C. Research designs for studies evaluating the effectiveness of change and improvement strategies. BMJ Qual. Saf. 12(1), 47–52 (2003).
•• Overview of study designs for evaluating quality improvement and patient safety programs.
5.
Oakley A, Strange V, Bonell C, Allen E, Stephenson J. Process evaluation in randomised controlled trials of complex interventions. BMJ 332(7538), 413–416 (2006).
6.
Greenhalght T, Robert G, Macfarlane F, Bate P, Kyriakidou O. Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q. 82(4), 581–629 (2004).
7.
Chang BH, Hsu Y-J, Rosen MA et al. Reducing three infections across cardiac surgery programs: a multi-site cross-unit collaboration. Unpublished Manuscript (2018). Nov. 15.
•• Evaluation of the Cardiovascular Surgical Translational Study using data collected by the project.
8.
Berenholtz SM, Lubomski LH, Weeks K et al. Eliminating central line-associated bloodstream infections: a national patient safety imperative. Infect. Control Hosp. Epidemiol. 35(1), 56–62 (2014).
9.
Pronovost P, Needham D, Berenholtz S et al. An intervention to decrease catheter-related bloodstream infections in the ICU. N. Engl. J. Med. 355(26), 2725–2732 (2006).
10.
Marsteller JA, Sexton JB, Hsu YJ, Hsiao CJ. A multicenter, phased, cluster-randomized controlled trial to reduce central line-associated bloodstream infections in intensive care units. Crit. Care Med. 40(11), 2933–2939 (2012).
• Randomized trial to examine the impact of the interventions in ICU setting.
11.
Horwitz LI, Krumholz HM, Green ML, Huot SJ. Transfers of patient care between house staff on internal medicine wards: a national survey. Arch. Intern. Med. 166(11), 1173–1177 (2006).
12.
Coleman EA, Berenson RA. Lost in transition: challenges and opportunities for improving the quality of transitional care. Ann. Intern. Med. 141(7), 533–536 (2004).
• Introduction to the care transition issues.
13.
Arora V, Johnson J, Lovinger D, Humphrey HJ, Meltzer DO. Communication failures in patient sign-out and suggestions for improvement: a critical incident analysis. BMJ Qual. Saf. 14(6), 401–407 (2005).
14.
Gurses AP, Kim G, Martinez EA et al. Identifying and categorising patient safety hazards in cardiovascular operating rooms using an interdisciplinary approach: a multisite study. BMJ Qual. Saf. 21(10), 810–818 (2012).
15.
Friedman DM, Berger DL. Improving team structure and communication: a key to hospital efficiency. Arch. Surg. 139(11), 1194–1198 (2004).
16.
Petersen LA, Orav EJ, Teich JM, O'Neil AC, Brennan TA. Using a computerized sign-out program to improve continuity of inpatient care and prevent adverse events. Jt. Comm. J. Qual. Improv. 24(2), 77–87 (1998).
17.
Van Eaton EG, Horvath KD, Lober WB, Rossini AJ, Pellegrini CA. A randomized, controlled trial evaluating the impact of a computerized rounding and sign-out system on continuity of care and resident work hours. J. Am. Coll. Surg. 200(4), 538–545 (2005).
18.
Wahr JA, Prager RL, Abernathy JH et al. Patient safety in the cardiac operating room: human factors and teamwork: a scientific statement from the American Heart Association. Circulation 128(10), 1139–1169 (2013).
19.
Werner NE, Gurses AP, Leff B, Arbaje AI. Improving care transitions across healthcare settings through a human factors approach. J. Healthcare Qual. 38(6), 328–343 (2016).
20.
Nasarwanji MF, Badir A, Gurses AP. Standardizing handoff communication: content analysis of 27 handoff mnemonics. J. Nurs. Care Qual. 31(3), 238–244 (2016).
21.
Hsu Y-J, Marsteller JA. Influence of the comprehensive unit-based safety program in ICUs: evidence from the Keystone ICU Project. Am. J. Med. Qual. (2015).
22.
Pronovost P, Weast B, Rosenstein B et al. Implementing and validating a comprehensive unit-based safety program. J. Patient Saf. 1(1), 33 (2005).
23.
Sawyer M, Weeks K, Goeschel CA et al. Using evidence, rigorous measurement, and collaboration to eliminate central catheter-associated bloodstream infections. Crit. Care Med. 38, S292–S298 (2010).
24.
Jacobs JP, Shahian DM, Prager RL et al. Introduction to the STS National Database Series: Outcomes analysis, quality improvement, and patient safety. Ann. Thorac. Surg. 100(6), 1992–2000 (2015).
25.
Jacobs JP, Shahian DM, He X et al. Penetration, completeness, and representativeness of The Society of Thoracic Surgeons Adult Cardiac Surgery Database. Ann. Thorac. Surg. 101(1), 33–41 (2016).
• More details about the Society of Thoracic Surgeons Adult Cardiac Surgery Database.
26.
Brock GN, Barnes C, Ramirez JA, Myers J. How to handle mortality when investigating length of hospital stay and time to clinical stability. BMC Med. Res. Methodol. 11(1), 144 (2011).
27.
Chan KS, Hsu YJ, Lubomski LH. Validity and usefulness of members reports of implementation progress in a quality improvement initiative: findings from the Team Check-up Tool (TCT). Implement. Sci. 6(1), 115 (2011).
28.
Marsteller JA, Hsu Y-J, Chan KS, Lubomski LH. Assessing content validity and user perspectives on the Team Check-up Tool: expert survey and user focus groups. BMJ Qual. Saf. 26(4), 1–8 (2016).
29.
Sox HC, Greenfield S. Comparative effectiveness research: a report from the Institute of Medicine. Ann. Intern. Med. 151(3), 203–205 (2009).
• Institute of Medicine report on comparative effectiveness research.
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© 2018 Future Medicine Ltd.
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Received: 1 June 2018
Accepted: 3 October 2018
Published online: 11 December 2018
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Using a society database to evaluate a patient safety collaborative: the Cardiovascular Surgical Translational Study. (2018) Journal of Comparative Effectiveness Research. DOI: 10.2217/cer-2018-0051
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- Barbara I. Braun, Salome O. Chitavi, Hiroyuki Suzuki, Caroline A. Soyemi, Mireia Puig-Asensio, Culture of Safety: Impact on Improvement in Infection Prevention Process and Outcomes, Current Infectious Disease Reports, 10.1007/s11908-020-00741-y, 22, 12, (2020).