Roberta Catunda, Bruna Bianchi Bilo, João Luís Farias, Magno F Formiga
{"title":"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。","authors":"Roberta Catunda, Bruna Bianchi Bilo, João Luís Farias, Magno F Formiga","doi":"10.1108/IJHCQA-02-2025-0012","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to assess the impact of plan-do-check-act (PDCA) cycles on tracheostomy weaning in ICU patients from 2019 through 2023.</p><p><strong>Design/methodology/approach: </strong>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).</p><p><strong>Findings: </strong>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 (<i>p</i> = 0.02), 2021-6.56 days (<i>p</i> = 0.00), 2022-7.80 days (<i>p</i> = 0.00) and 2023-8.74 days (<i>p</i> = 0.00). Subgroup analysis also revealed significant differences in weaning time among baseline, post-first PDCA cycle and post-second PDCA cycle (<i>F</i> (2) = 20.15, <i>p</i> = 0.00, η2 = 0.51).</p><p><strong>Originality/value: </strong>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.</p>","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":" ","pages":""},"PeriodicalIF":1.0000,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Optimizing tracheostomy weaning with PDCA cycles: a four-year multidisciplinary quality improvement initiative in Northeast Brazil.\",\"authors\":\"Roberta Catunda, Bruna Bianchi Bilo, João Luís Farias, Magno F Formiga\",\"doi\":\"10.1108/IJHCQA-02-2025-0012\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>We aimed to assess the impact of plan-do-check-act (PDCA) cycles on tracheostomy weaning in ICU patients from 2019 through 2023.</p><p><strong>Design/methodology/approach: </strong>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).</p><p><strong>Findings: </strong>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 (<i>p</i> = 0.02), 2021-6.56 days (<i>p</i> = 0.00), 2022-7.80 days (<i>p</i> = 0.00) and 2023-8.74 days (<i>p</i> = 0.00). Subgroup analysis also revealed significant differences in weaning time among baseline, post-first PDCA cycle and post-second PDCA cycle (<i>F</i> (2) = 20.15, <i>p</i> = 0.00, η2 = 0.51).</p><p><strong>Originality/value: </strong>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.</p>\",\"PeriodicalId\":47455,\"journal\":{\"name\":\"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.0000,\"publicationDate\":\"2025-05-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1108/IJHCQA-02-2025-0012\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"HEALTH POLICY & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1108/IJHCQA-02-2025-0012","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"HEALTH POLICY & SERVICES","Score":null,"Total":0}
Optimizing tracheostomy weaning with PDCA cycles: a four-year multidisciplinary quality improvement initiative in Northeast Brazil.
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.
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.
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