Scaling Up Quality Improvement for Surgical Teams

Conditions

Healthcare service delivery Not Applicable Healthcare service delivery

Scrimshire AB, Booth A, Fairhurst C, Coleman E, Malviya A, Kotze A, Tiplady C, Tate D, Laverty A, Davis G, Tadd W, Corbacho B, Torgerson DJ, McDaid C, Reed M, QIST collaborators.

2022-03-123 citations

10.1186/s13012-022-01193-9

Scaling up Quality Improvement for Surgical Teams (QIST) - avoiding surgical site infection and anaemia at the time of surgery: protocol for a cluster randomised controlled trial.

Scrimshire AB, Booth A, Fairhurst C, Reed M, Tadd W, Laverty A, Corbacho B, Torgerson D, McDaid C.

2020-02-286 citations

10.1186/s13063-020-4152-3

Interventions

Current interventions as of 01/07/2019: The study intervention is a Breakthrough Series Collaborative model. A Collaborative is a short-term learning system that brings together a larg

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: 1. NHS Acute Trust 2. Commitment from Trust Executive that consent to participate will be provided if Trust is recruited

Exclusion criteria

Exclusion criteria: 1. Quality improvement initiative for screening and pre-operative treatment of anaemia and/or screening for and decolonisation of MSSA already in routine practice for orthopaedic surgical patients.

Design outcomes

Primary

Measure	Time frame
Current primary outcome measures as of 01/07/2019: 1. Anaemia is measured using the Blood transfusion within 7 days following surgery 2. Deep infection is measured using the Public Health England and Centre for Disease Control and Prevention definition, both at 90 days post-surgery. Previous primary outcome measures: 1. Anaemia is measured using the Blood transfusion within 7 days following surgery 2. Deep infection is measured using Centre for Disease Control and Prevention definition at 90 days post-surgery	—

Measure

Time frame

Current primary outcome measures as of 01/07/2019: 1. Anaemia is measured using the Blood transfusion within 7 days following surgery 2. Deep infection is measured using the Public Health England and Centre for Disease Control and Prevention definition, both at 90 days post-surgery. Previous primary outcome measures: 1. Anaemia is measured using the Blood transfusion within 7 days following surgery 2. Deep infection is measured using Centre for Disease Control and Prevention definition at 90 days post-surgery

—

Secondary

Measure	Time frame
Current secondary outcome measures as of 01/07/2019: 1. Patient-level outcomes are measured using: 1.1. Superficial infection up to 30 days post-surgery, and name of pathogen (if known) 1.2. Length of hospital stay in days (number of midnights spent in hospital) 1.3. Re-admission within 30 days of discharge 1.4. Critical care admission within 30 days of surgery (regardless of previous discharge) 1.5. Number of days spent in critical care within 30 days of surgery (number of midnights spent in the unit) 2. Process measured for QIST infection are: 2.1. Date patient screened for MSSA 2.2. Results 2.3. Date decolonising pack dispensed 2.4. Confirmation used by the patient: Yes/No/Not recorded 3. Process measures for QIST Anaemia are 3.1. Date patient screened for anaemia 3.2. Date pre-op treatment for anaemia given 3.3. Pre-operative blood results: 3.3.1. Hb 50 3.4. Was iron indicated: Yes/No/Not recorded 3.5. Was iron given to the patient: Yes/No/Not recorded Aggregated baseline data will be extracted for the 12 months prior to the commencement of the trial. Individual patient data will be extracted monthly from one month after commencement of the trial to feed into the delivery of the intervention. Final data collection point will be one year and four months after start of data collection. Previous secondary outcome measures: 1. Patient-level outcomes are measured using: 1.1. Superficial infection up to 90 days post-surgery, and name of pathogen (if known) 1.2. Length of hospital stay in days (number of midnights spent in hospital) 1.3. Re-admission within 30 days of discharge	—

Measure

Time frame

Current secondary outcome measures as of 01/07/2019: 1. Patient-level outcomes are measured using: 1.1. Superficial infection up to 30 days post-surgery, and name of pathogen (if known) 1.2. Length of hospital stay in days (number of midnights spent in hospital) 1.3. Re-admission within 30 days of discharge 1.4. Critical care admission within 30 days of surgery (regardless of previous discharge) 1.5. Number of days spent in critical care within 30 days of surgery (number of midnights spent in the unit) 2. Process measured for QIST infection are: 2.1. Date patient screened for MSSA 2.2. Results 2.3. Date decolonising pack dispensed 2.4. Confirmation used by the patient: Yes/No/Not recorded 3. Process measures for QIST Anaemia are 3.1. Date patient screened for anaemia 3.2. Date pre-op treatment for anaemia given 3.3. Pre-operative blood results: 3.3.1. Hb 50 3.4. Was iron indicated: Yes/No/Not recorded 3.5. Was iron given to the patient: Yes/No/Not recorded Aggregated baseline data will be extracted for the 12 months prior to the commencement of the trial. Individual patient data will be extracted monthly from one month after commencement of the trial to feed into the delivery of the intervention. Final data collection point will be one year and four months after start of data collection. Previous secondary outcome measures: 1. Patient-level outcomes are measured using: 1.1. Superficial infection up to 90 days post-surgery, and name of pathogen (if known) 1.2. Length of hospital stay in days (number of midnights spent in hospital) 1.3. Re-admission within 30 days of discharge

—

Countries

England, United Kingdom

Outcome results

None listed