التفاصيل البيبلوغرافية
| العنوان: |
Hospital-level evaluation of the effect of a national quality improvement programme: time-series analysis of registry data |
| المؤلفون: |
Stephens, Timothy J, Peden, Carol J, Haines, Ryan, Grocott, Mike P W, Murray, Dave, Cromwell, David, Johnston, Carolyn, Hare, Sarah, Lourtie, Jose, Drake, Sharon, Martin, Graham P, Pearse, Rupert M, On behalf of Enhanced Perioperative Care for High-risk patients (EPOCH) trial group, Pearse, Ruper, Peden, Carol, Stephens, Tim, Bion, Julian, Martin, Graham, Thomson, Ann, Kahan, Brennan, Kerry, Sally, Rivett, Kate, Wells, Duncan, Richardson, Gerry, Brett, Stephen, Ackland, Gareth, Grocott, Mike, Holt, Peter, Robert, Glenn, Ukoumunne, Obioha, Waring, Justin, Everingham, Kirsty, Phull, Mandeep, Evley, Rachel, Lilford, Richard, Kocman, David, Asaria, Miqdad, Tarrant, Carolyn, Yang, Fan, Abraham, Ajit, Bothma, Pieter, Conway, Daniel, Stapleton, Clare, Edwards, Mark, Minto, Gary, Saunders, David, Owen, Tom, Waldmann, Carl, Hayden, Paul, Gillies, Michael, Tighe, Sean, Smith, Neil, Mythen, Monty, Murray, David, Lobo, Dileep, Leuwer, Martin, Kirk-Bayley, Justin, Howell, Simon, Gordon, Anthony, Anderson, Iain, Walker, Simon, Watson, Nick, Szakmany, Tamas, Sutcliffe, Robert, Mahajan, Ravi, Girling, Alan, Forbes, Gordon, Faiz, Omar, Blunt, Mark, Singh, Surjait, Steel, Alistair, Wong, Kate, Cabreros, Leilani, Chitre, Vivek, Obideyi, Ayodele, Ali, Dhiraj, Blenk, Karl, Broad, Dan, Brodbeck, Andreas, Dumpala, Rajesh, Engel, Arnth, Ganepola, Ranjit, Garg, Sudha, Gay, Mike, Karlikowsk, Michael, Lams, Edward, Millican, Dean, Misane, Inga, Mull, Ajaya, Naik, Veena, Pushpa, Nathan, Nutt, Chris, Sagadai, Saravanna, Stuart, Hazel, Noble, Paul, Velde, Niko Van De, Hudson, Liam, Benlloch, Raoul, Singh, Satish, Verma, Karan, Laba, Damian, Carmichael, Jack, Richardson, Peter, Wilson, Graham, Lewis, Ricky, Surendran, Karthik, El-Damatty, Essam, Gurung, Sarada, Raulusaite, Ilona, Gerstina, Nabua, Rochester, Chloe, Kuldip, Rai, Lindner, Andrew, Murray, Therese, Lal, Roshan, Downey, Sarah, Velchuru, Vamsi, Aryal, Kamal, Guruswamy, Raman, Shankar, Kirosh, Porter, Helen, Tutton, Matthew, Agostini, Helen, Fletcher, Simon, Wharton, Richard, Hutchinson, Steve, Maiya, Bala, Howard-Griffin, Richard, Crabtree, Michael, Kushakovsky, Vlad, Abdel Omer, Senthil Nadarajavan, Bell, Stephanie, Patil, Vishal, Jah, Asif, Mahroof, Razeen, Watson, Nicholas, Tansley, John, Moncaster, Gareth, Flint, Neil, Miller, Andrew, Wood, Marcus, Prematie, Andreou, Roth, Sally, Bowery, Sarah, Hales, Dawn, Shah, Tanuja, Tierney, Gill, Morris, Craig, Iftikhar, Syed, Shukla, Amit, O'Dwyer, Grainne, Wolverson, Adam, Adams, Ferdinand, Perrin-Brown, Laura, White, Tim, Beavis, Sarah, Banks, Victoria, Abercrombie, John, Mole, Jonathon, Chana, Avninder, Banerjea, Ayan, Humes, David, Dhingsa, Rajpal, Wells, John, Brown, Stephanie, Adegoke, Kenneth, Tofte, Barclay, Alegria, Ana, Natarajan, Nat, Akhtar, Mansoor, Doughan, Samer, Mackinnon, John, Aravind, Biju, Cook, Esther, Snazelle, Mark, Gardner, Matt, Baldwin, Lee, Bailey, Simon, Lawton, Greg, Divekar, Nandita, Kukreja, Neil, Sange, Mansoor, Watson, Mark, Satisha, Mallikarjunappa, Protopapas, Michael, Belagodu, Zakaulla, Sarfi, Shameem, Raju, Pasupathy, Stacey, Brenda, Campbell-Smith, Tim, Parrington, Simon, Desikan, Somi, Brennan, Andrew, Griffith, John, Fletcher, Steve, Farrow, Catherine, Prestwich, Stewart, Graham, Laura, Northey, Martin, Gokhale, Jay, Mosley, Frances, Alexander, Peter, Sharma, Abhiram, Brady, Will, Hopper, John, Hill, Oliver, Varma, Sandeep, Macklin, Christopher, Rose, Alastair, Narula, Harjeet, Buckley, Sarah, Simeson, Karen, Sim, Kevin, Chadwick, Michael, Kuduvalli, Preeti, Dowling, Susan, McCairn, Amanda, Wilson, Lawrence, Vimalchandran, Dale, Jhamatt, Anita, Robin, Nicole, Monk, David, Bottomley, David, Zuzan, Oliver, Welters, Ingeborg, Ross-Anderson, Davina, Knowles, Charles, Bunker, Nick, Hu, Ying, Januszewska, Marta, Bodger, Phoebe, Niebrzegowska, Edyta, Correia, Carmen, Haslop, Richard, Abbott, Tom, Tanqueray, Tabitha, Wijeykoon, Sanjay, Jain, Susan, Full, Jens, Cuming, Tamzin, Bailey, Flora, Chatzimichail, Stelios, Cunha, Pedro, Rehman, Almas, Mohanty, Manab, Radford, Nicola, Mohr, Otto, Patel, Hitesh, Mateo, Dolores, Raj, Ashok, Machesney, Michael, Abdul, Nazar, Jemmet, Kim, Campbell, Marta, Inglis, David, Parker, Thomas, Medici, Thomas, Chan, Peter, Borgeaud, Nathan, Mukherjee, Dipankar, Odejinmi, Oluremi, Jovaisa, Tomas, Harwood, Elizabeth, Moonesinghe, Ramani, Mccullough, Jonathan, Modha, Jigna, Patel, Sanjiv, Limb, James, Bengeri, Sheshagiri, Rafi, Amir, Hall, Elizabeth, Brown, James, Gibson, Bruce, McNelis, Una, Bradburn, Mike, Lawson, Maria, Pick, Sara, Gaughan, Matthew, Browell, David, Linnett, Vanessa, Ritzema, Jenny, O'Loughlin, Paul, Cope, Sean, Corson, John, Roy, Alistair, Furneval, Julie, Holtham, Anitha, Noblett, Sophie, Dawson, Chris, McMenemie, Fiona, Pulsa, Stefan, Clement, Ian, Calder, Verity, Allen, Katherine, Rimmer, Catherine, Reed, Helen, Boyd, Christine, Monkhouse, Diane, Davies, Peter, Mullenheim, Jost, Cirstea, Emanuel, Cain, Martyn, Baillie, Kirsty, Bhowmick, Arnab, Jovestani, Keiarash, Mcmullan, Sean, Durant, Emma, Williams, Alexandra, Doyle, Donna, Cupitt, Jason, Barker, Jonathon, Harper, Nick, Brennan, Emma, Subar, Daren, Shawcross, Robert, Sebastian, Dominic, Patel, Panna, O'Connell, Gillian, Karvonen, Jyrki, Ishaan, Maitra, Hool, Alison, Burns, Karen, Mcarthur, Carol, Stergios, Tezas, Gursevak, Singh, Sonia, Makvana, Pratt, Heather, Lynne, Kaighan, McAfee, Sean, Lewis, Chris, Khalaf, Wael, Coldwell, Chris, Bronder, Christine, Wilkinson, Mark, Davis, Emma, Arnold, Glenn, Ziprin, Paul, Bartlett, Rachel, Stotz, Martin, D'souza, Rovan, Pemberton, Phillippa, Agarwal, Banwari, Sugavanam, Anita, Tan, Melanie, Varcada, Massimo, Lyness, Craig, Thorniley, Andrew, Prabhudesai, Ash, Griffin, Ruth, Vashisht, Shubha, Harris, James, Wakeford, Julie, Vaganov, Sergei, Mohsen, Yasser, Myers, Alister, Iqbal, Qamar, Harris, Simon, Ijaz, Sami, Burrow, James, Rubulotta, Francesca, El-Masry, Nabil, Stranix, Nicola, Rope, Tamsin, Liasis, Lampros, Husain, Tariq, Watfah, Josef, Griffiths, Megan, Warusavitarne, Janindra, Cartwright, Charles, Baxter, Linden, Visavadia, Rakhee, Sim, Malcolm, Wilson, Chris, Harrison, Paul, Williams, Dewi, Bews-Hair, Maria, Wrathall, Wayne, Jardine, Catherine, Mclaren, Paul, Dreyer, Fanus, Collins, Paddy, Edwards, Jennifer, Moug, Susan, Rooney, Kevin, Mcilveen, Erin, Henderson, Steven, Graham, Linda, Stark, Gail, Taylor, Lynn, Munro, Mark, Stewart, Lynn, Dickinson, Natalie, Rooney, Laura, Bailey, Lindsay, Murray, Diane, Geary, Tim, Gibson, Simon, Pow, Colin, Tan, Kerwei, Stevenson, Richard, Harrison, Ewen, Lamb, Peter, Carey, Kate, Fitton, Laura, Cook, Fabian, Schwarz, Magen, Morrison, Alan, Bryce, Gavin, Razouk, Khaled, Cain, Kathryn, Kunst, Gudrun, Papagrigoriadis, Savvas, Hopkins, Phil, Fawcet, Adrian, O'Carroll-Kuehn, Britta, Girgis, Amira, Janokowski, Stas, Farhat, Sami, Vig, Stella, Hadi, Nada, Parsons, Anthony, Cecconi, Maurizio, Melville, David, Hartopp, Richard, Woods, Justin, Karat, Isabella, Gerrard, David, Curtis, Edward, Somasekar, Krishnamurthy, Morgan-Jones, Tom, Martin, Michael, Henwood, Mark, Milne, Gordon, Sivasankaranand, Ajit, Scott, Alexandra, Escofet, Xavier, Toth-Tarsoly, Piroska, Shama, Majed Al, Hilton, Valerie, Davis, Huw, Williams, Gail, Harvard, Tim, Fitzgerald, Peter, Hurford, Dom, Muthuswamy, Babu, Williams, Gethin, Jones, Jack Parry, Mason, Nick, Rajagopal, Ramesh, Shenoy, Shrisha, Khater, Magdy, Morgan, Richard, Makris, Nikolaos, Hermandes, Anil, White, Andrew, Finch, Guy, Outram, Matt, Wilkinson, Jonny, Spimpolo, Jennifer, Shaw, Debbie, Obichere, Marion, Brescia, Giovanni, Menezes, Flavia, Stafford, Helena, Watters, Malcolm, Thorn, Chris, Stone, Julian, Andrews, Sam, Lythell, Nicola, Langton, Helen, Baxter, Stephen, Fernandes, Roy, Sunthareswaran, Rame, Ankers, Alastair, Panikkar, Kumar, Sleight, Simon, Cornforth, Belinda, Bell, Louise, Dodd, Phil, Welsh, Fenella, Watson, Geoff, Dorman, Frankie, Nash, Guy, Bromilow, James, Haigh, Fran, Pogson, David, Mercer, Stuart, Tucker, Vanessa, Way, Carolyn, Kirby-Bott, James, McLachan, Jenny, Chambers, Rob, Craven, Rachael, Blazeby, Jane, Freshwater-Turner, Dan, Burrows, Lorna, Howes, Helen, Christie, Iain, Coleman, Mark, Waddy, Sam, Sanders, Grant, Patrick, Abigail, Pitman, Catherine, Tyson, Susan, Smith, Hannah, Rousseau, Guy, Cartmell, Mark, Hanousek, Jan, Hollister, Nigel, Kightly, Lynsey, Pulletz, Mark, Talwar, Anjay, Baker, Susie, Thomas, Ruth, Gibbs, Richard, Noble, Hamish, Silsby, Joseph, Black, Helen, Evans, Thomas, DeBrunner, Robert, Cook, Nicola, Hodges, Stacy, Stevens, Amanda, Felipe, Rowena, Paddle, Jonathan, May, Denzil, Pickford, Alison, Riddington, Sid, Tucker, Olga, Smart, Simon, Marwick, Jeremy, Suggett, Nigel, Griffiths, Ewen, Riddington, David, Gill, Kathryn, Cruickshank, Neil, Susarla, Jay, Leno, Emma, Colley, Julie, Burtenshaw, Andrew, Lake, Stephen, Greenwood, Jamie, Bhardwaj, Sian, Thrush, Jessica, Wollaston, Julie, Sonksen, Julian, Patel, Rajan, Jennings, Adrian, Stanley, David, Wright, Jenny, Horner, Chris, Baig, Faisal, Cooke, Katie, Singh, Jagdeep, Claxton, Andrew, Mirza, Nazzia, Hester, Simon, Knight, Georgia, Kumar, Peeyush, Saran, Taj, Marangoni, Gabriele, Townsend, Roger, Thacker, Andy, Scase, Anne, Sharma, Meghna, Hale, Beth |
| بيانات النشر: |
BMJ Publishing Group Ltd |
| سنة النشر: |
2020 |
| المجموعة: |
HighWire Press (Stanford University) |
| مصطلحات موضوعية: |
Original research |
| الوصف: |
Background and objectives A clinical trial in 93 National Health Service hospitals evaluated a quality improvement programme for emergency abdominal surgery, designed to improve mortality by improving the patient care pathway. Large variation was observed in implementation approaches, and the main trial result showed no mortality reduction. Our objective therefore was to evaluate whether trial participation led to care pathway implementation and to study the relationship between care pathway implementation and use of six recommended implementation strategies. Methods We performed a hospital-level time-series analysis using data from the Enhanced Peri-Operative Care for High-risk patients trial. Care pathway implementation was defined as achievement of >80% median reliability in 10 measured care processes. Mean monthly process performance was plotted on run charts. Process improvement was defined as an observed run chart signal, using probability-based ‘shift’ and ‘runs’ rules. A new median performance level was calculated after an observed signal. Results Of 93 participating hospitals, 80 provided sufficient data for analysis, generating 800 process measure charts from 20 305 patient admissions over 27 months. No hospital reliably implemented all 10 processes. Overall, only 279 of the 800 processes were improved (3 (2–5) per hospital) and 14/80 hospitals improved more than six processes. Mortality risk documented (57/80 (71%)), lactate measurement (42/80 (53%)) and cardiac output guided fluid therapy (32/80 (40%)) were most frequently improved. Consultant-led decision making (14/80 (18%)), consultant review before surgery (17/80 (21%)) and time to surgery (14/80 (18%)) were least frequently improved. In hospitals using ≥5 implementation strategies, 9/30 (30%) hospitals improved ≥6 care processes compared with 0/11 hospitals using ≤2 implementation strategies. Conclusion Only a small number of hospitals improved more than half of the measured care processes, more often when at least five of six implementation ... |
| نوع الوثيقة: |
text |
| وصف الملف: |
text/html |
| اللغة: |
English |
| العلاقة: |
http://qualitysafety.bmj.com/cgi/content/short/29/8/623Test; http://dx.doi.org/10.1136/bmjqs-2019-009537Test |
| DOI: |
10.1136/bmjqs-2019-009537 |
| الإتاحة: |
https://doi.org/10.1136/bmjqs-2019-009537Test
http://qualitysafety.bmj.com/cgi/content/short/29/8/623Test |
| حقوق: |
Copyright (C) 2020, BMJ Publishing Group Ltd |
| رقم الانضمام: |
edsbas.76AE13BC |
| قاعدة البيانات: |
BASE |
