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J Cardiothorac Vasc Anesth. 2013 Dec;27(6):1194-200. doi: 10.1053/j.jvca.2013.02.028. Epub 2013 Sep 2.

Evaluation of the impact of a quality improvement program and intensivist-directed ICU team on mortality after cardiac surgery.

Author information

1
Departments of *Cardiac Surgery and. Electronic address: alexander.kogan@sheba.health.gov.il.

Abstract

OBJECTIVE:

Quality improvement is an important pursuit for critical care teams.

DESIGN:

The authors performed an observational cohort study with historic control.

SETTING:

Eight-bed cardiac surgery ICU in a tertiary university hospital.

PARTICIPANTS:

A total of 4,866 patients undergoing cardiac surgery over a 6-year period between January 2005 and December 2010.

INTERVENTIONS:

In this study, the influence of the introduction of a quality improvement program under the supervision of a newly appointed intensivist on patient outcomes after cardiac surgery was evaluated. Patients were further divided into three 2-year periods: Period I, 2005-2006, before appointment of an intensivist; Period II, 2007-2008, after appointment of an intensivist and initial introduction of a quality improvement program; and Period III, 2009-2010, after implementation of the program and introduction of Critical Care Information Systems.

MEASUREMENTS AND MAIN RESULTS:

There were 1,633, 1,690, and 1,543 patients in each period, respectively. There was no significant difference in the severity of patient illness between the groups. Unadjusted in-hospital mortality decreased from 6.37% (104 patients) in Period I to 4.32% (73 patients) and 3.3% (51 patients) in Periods II and III, respectively (p< 0.01).

CONCLUSIONS:

Appointment of an intensivist-directed team model and introduction of quality improvement interventions were associated with decreased mortality after cardiac surgery.

KEYWORDS:

cardiac surgery; postoperative care; quality improvement

PMID:
24008163
DOI:
10.1053/j.jvca.2013.02.028
[Indexed for MEDLINE]
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