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Related Experiment Videos

Changing surgical practice through feedback of performance data.

Jacqueline Reilly1, Jean McIntosh, Kay Currie

  • 1Lanarkshire Acute Hospitals NHS Trust, Lanarkshire, UK. jacquireilly@yahoo.co.uk

Journal of Advanced Nursing
|June 18, 2002
PubMed
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Passive feedback of surgical infection rates did not significantly reduce infections. However, implementing evidence-based practice guidelines led to a significant decrease in surgical wound infections, highlighting the importance of active feedback and change theory.

Area of Science:

  • Healthcare quality improvement
  • Surgical safety
  • Evidence-based practice

Background:

  • Clinical audit and performance data feedback are common methods to change healthcare practices.
  • Empirical evidence for the effectiveness of clinical audit in practice change is limited.
  • Few studies link practice development or clinical outcomes to change theory frameworks.

Purpose of the Study:

  • To evaluate the impact of passive feedback of surgical wound infection rates on infection rates.
  • To assess the effect of active feedback of infection rate data within a normative re-educative change approach.
  • To compare different feedback strategies in influencing surgical practice and outcomes.

Main Methods:

  • A prospective cohort study of 2241 patients undergoing clean elective surgery over 3 years.

Related Experiment Videos

  • 'Gold standard' surveillance, including community follow-up, was used to determine surgical wound infection rates.
  • Interventions involved periods of feedback, withdrawal of feedback, and introduction of evidence-based practice guidelines within a change theory framework.

    • Main Results:

    • Passive feedback of infection rate data showed a non-statistically significant impact on subsequent infection rates.
    • A statistically significant reduction in surgical wound infection rates was observed after introducing guidelines for best surgical practice (P < 0.05).
    • The study monitored infection incidence during different intervention periods.

    Conclusions:

    • Passive feedback alone is insufficient to significantly change surgical practice and reduce infection rates.
    • Active feedback, integrated within a normative re-educative approach to change, is more effective.
    • Implementing evidence-based practice guidelines is a key strategy for improving surgical outcomes.