建立一个由外科医生领导的成人心脏手术质量改进计划

IF 1.3 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Ahmet Can Topcu, Fatih Yigit, Emin Onur Yerlikhan, Mustafa Mert Ozgur, Melike Turkal, Hakan Hancer, Kamile Ozeren-Topcu, Farid Gojayev, Ozgul Uzunca, Serpil Tas, Kaan Kirali
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引用次数: 0

摘要

目的介绍科苏友鲁成人心脏外科质量改进方案的建立过程中所采用的方法,分享我们的初步经验,并对今后的发展方向提出一些见解。方法从一个高绩效协作质量倡议的著名案例中获得启发,我们建立了一个由资深学术和早期职业外科医生自愿参与的以外科医生为主导的质量改进计划。我们的新项目旨在通过数据采集和分析、内部数据验证、关于护理过程和风险调整结果的协作讨论以及质量改进计划的开发和实施来提高心脏外科护理的质量。结果:我们观察到围手术期血液利用率、术后机械通气时间和术后住院时间等结局指标的基线差异显著。在Kosuyolu成人心脏手术质量改善项目的前2年,在接受孤立冠状动脉搭桥手术的所有患者中,多动脉移植率和所有心脏手术后未调整的再探查率从基线开始有了显著的总体改善。然而,围手术期血液利用率、术后机械通气时间以及住院和重症监护病房的住院时间没有明显改善。结论外科医生主导的协同质量改进项目有助于提高心脏外科患者的医疗服务质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Establishing a Surgeon-Led Adult Cardiac Surgery Quality Improvement Program

Establishing a Surgeon-Led Adult Cardiac Surgery Quality Improvement Program

Objective

The current article describes the methods utilized during the establishment of Kosuyolu Adult Cardiac Surgery Quality Improvement Program, shares our initial experiences, and provides insights into future directions.

Methods

Through inspiration from a notable example of high-performing collaborative quality initiative, we established a surgeon-led quality improvement program by voluntary participation of senior academic and early-career surgeons. Our new program aims to improve the quality of cardiac surgical care through methods of data acquisition and analysis, internal data validation, collaborative discussions on care processes and risk-adjusted outcomes, and development and implementation of quality improvement initiatives.

Results

We observed significant baseline variations in outcome measures including perioperative blood utilization, postoperative mechanical ventilation duration, and postoperative length of stay between surgeon groups. During the first 2 years of the Kosuyolu Adult Cardiac Surgery Quality Improvement Program, there were significant overall improvements from baseline in multiarterial grafting rates among all-comer patients undergoing isolated coronary artery bypass surgery and in unadjusted re-exploration rates after all cardiac surgical procedures. However, no significant improvements were noted in perioperative blood utilization, postoperative mechanical ventilation duration and hospital and intensive care unit length of stay.

Conclusion

Surgeon-led collaborative quality improvement programs are instrumental in enhancing the quality of healthcare services provided to cardiac surgical patients.

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来源期刊
CiteScore
2.90
自引率
12.50%
发文量
976
审稿时长
3-8 weeks
期刊介绍: Journal of Cardiac Surgery (JCS) is a peer-reviewed journal devoted to contemporary surgical treatment of cardiac disease. Renown for its detailed "how to" methods, JCS''s well-illustrated, concise technical articles, critical reviews and commentaries are highly valued by dedicated readers worldwide. With Editor-in-Chief Harold Lazar, MD and an internationally prominent editorial board, JCS continues its 20-year history as an important professional resource. Editorial coverage includes biologic support, mechanical cardiac assist and/or replacement and surgical techniques, and features current material on topics such as OPCAB surgery, stented and stentless valves, endovascular stent placement, atrial fibrillation, transplantation, percutaneous valve repair/replacement, left ventricular restoration surgery, immunobiology, and bridges to transplant and recovery. In addition, special sections (Images in Cardiac Surgery, Cardiac Regeneration) and historical reviews stimulate reader interest. The journal also routinely publishes proceedings of important international symposia in a timely manner.
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