Optimizing tracheostomy weaning with PDCA cycles: a four-year multidisciplinary quality improvement initiative in Northeast Brazil.

IF 1 Q4 HEALTH POLICY & SERVICES

INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE Pub Date : 2025-05-16 DOI:10.1108/IJHCQA-02-2025-0012

Roberta Catunda, Bruna Bianchi Bilo, João Luís Farias, Magno F Formiga

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引用次数: 0

Abstract

Purpose: We aimed to assess the impact of plan-do-check-act (PDCA) cycles on tracheostomy weaning in ICU patients from 2019 through 2023.

Design/methodology/approach: A retrospective study was conducted at a private hospital, analyzing recorded data from two PDCA cycles that were implemented to reduce mean tracheostomy weaning times between 2019 and 2023. We further classified distinct timeframes for a separate analysis, including the baseline (April 2019-August 2020), the period post-PDCA cycle I (January 2021-April 2022) and the period post-PDCA cycle II (August 2022-December 2023).

Findings: A total of 70 individuals completed the protocol (mean age ± SD, 60.51 ± 17.19 years; 31.4% female). One-way ANOVA revealed mean differences in weaning time compared to 2019 were significant: 2020-3.86 days (p = 0.02), 2021-6.56 days (p = 0.00), 2022-7.80 days (p = 0.00) and 2023-8.74 days (p = 0.00). Subgroup analysis also revealed significant differences in weaning time among baseline, post-first PDCA cycle and post-second PDCA cycle (F (2) = 20.15, p = 0.00, η2 = 0.51).

Originality/value: This management model underscores the benefits of consistently improving the quality management of physiotherapy, delivering value-based healthcare through the collaboration of a multidisciplinary team.

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通过PDCA循环优化气管切开术脱机：巴西东北部一项为期四年的多学科质量改进计划。

目的：我们旨在评估计划-执行-检查-行动（PDCA）周期对2019年至2023年ICU患者气管切开术脱机的影响。设计/方法/方法：在一家私立医院进行了一项回顾性研究，分析了2019年至2023年间实施的两次PDCA循环的记录数据，以减少平均气管切开术脱机次数。我们进一步对不同的时间框架进行了单独的分析，包括基线（2019年4月- 2020年8月）、pdca后周期I（2021年1月- 2022年4月）和pdca后周期II（2022年8月- 2023年12月）。结果：共有70人完成了方案(平均年龄±SD， 60.51±17.19岁；31.4%的女性)。单因素方差分析显示，与2019年相比，断奶时间的平均差异显著：2020-3.86天（p = 0.02）、2021-6.56天（p = 0.00）、2022-7.80天（p = 0.00）和2023-8.74天（p = 0.00）。亚组分析还显示，基线、第一次PDCA循环后和第二次PDCA循环后的断奶时间差异有统计学意义（F (2) = 20.15, p = 0.00, η2 = 0.51）。原创性/价值：这种管理模式强调了不断提高物理治疗质量管理的好处，通过多学科团队的协作提供基于价值的医疗保健。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE HEALTH POLICY & SERVICES-

CiteScore

4.00

自引率

6.70%

发文量

期刊介绍： ■Successful quality/continuous improvement projects ■The use of quality tools and models in leadership management development such as the EFQM Excellence Model, Balanced Scorecard, Quality Standards, Managed Care ■Issues relating to process control such as Six Sigma, Leadership, Managing Change and Process Mapping ■Improving patient care through quality related programmes and/or research Articles that use quantitative and qualitative methods are encouraged.