References
Implementing Quality Improvement
- Alnababteh, M.H. et al. A Multimodal Sepsis Quality-Improvement Initiative Including 24/7 Screening and a Dedicated Sepsis Response Team-Reduced Readmissions and Mortality(link is external). Crit Care Explor 2020.
- After the implementation of multimodal sepsis performance initiatives, observations included a higher prevalence of sepsis secondary to screening but a lower prevalence of severe sepsis and septic shock, an improvement in compliance with the sepsis bundle interventions bundle, as well as reduction in hospital readmission and all-cause mortality rate.
- Perlin, J.B. et al. Eisenberg Patient Safety and Quality Awards: SPOTting Sepsis to Save Lives: A Nationwide Computer Algorithm for Early Detection of Sepsis: Innovation in Patient Safety and Quality at the National Level(link is external)(Eisenberg(link is external) Award).(link is external)Jt Comm J Qual Patient Saf 2020.
- Development of the Sepsis Prediction and Optimization of Therapy(SPOT) algorithm for the detection of sepsis from data available in the electronic health record resulted in more timely recognition, faster initiation of treatment, and improved survival for patients.
- Soane, L. et al. Using quality improvement principles to improve the care of patients with severe sepsis and septic shock(link is external). Ochsner J. 2013
- A multidisciplinary team approach to sepsis management using protocols and early goal-directed therapy is feasible in a large academic medical center to improve the process of care and outcomes.
Evaluation of Effectiveness
- Clarke, G.M. et al. Evaluating the impact of healthcare interventions using routine data(link is external). BMJ 2019.
- Evaluation is an essential part of understanding what impact changes are having, for whom and in what circumstances, and help inform future decisions about improvement and further roll out. There is no standard,‘‘one size fits all’’ recipe for a good evaluation: it must be tailored to the project at hand.
- Parry, G. et al. Practical recommendations for the evaluation of improvement initiatives(link is external). Int J Qual Health Care 2018.
- This paper provides recommendations to inform funders and evaluators on what to look for when evaluating improvement initiatives. Evaluation designs must consider the iterative, adaptive nature of improvement.
Sustaining Improvement
- Doyle, C. et al. Making change last: applying the NHS institute for innovation and improvement sustainability model to healthcare improvement.(link is external)Implement Sci. 2013
- The Sustainability Model provides a potentially useful approach to measuring teams’ view on the likelihood of sustainability and prompting action.
- Hibbert, P.D. et al. How to sustainably build capacity in quality improvement within a healthcare organization: A deep-dive, focused qualitative analysis(link is external). BMC Health Serv Res 2021.
- This study revealed interacting components that were deemed necessary for a successful QI program: active involvement of leadership and management, a skilled faculty to assist teams, an agreed and robust QI system, and an understanding that teams matter.
- Silver, S.A. et al. How to Sustain Change and Support Continuous Quality Improvement(link is external). Clin J Am Soc Nephrol 2016.
- To achieve sustainable change, quality improvement initiatives must become the new way of working rather than something added on to routine clinical care. Tools to help sustain improvement include process control boards, performance boards, standard work, and improvement huddles.