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Continuous quality improvement in nephrology: a systematic review.

Julie Wright Nunes1, F Jacob Seagull2, Panduranga Rao3

  • 1Department of Internal Medicine, Division of Nephrology, University of Michigan Health System, Ann Arbor, MI, USA. juwright@med.umich.edu.

BMC Nephrology
|November 25, 2016
PubMed
Summary

Continuous quality improvement (CQI) has seen limited rigorous evaluation in nephrology, despite its business success. More research is needed to understand how CQI impacts kidney care outcomes and justifies reimbursement.

Keywords:
Continuous quality improvementKidney diseaseSystematic review

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Area of Science:

  • Nephrology
  • Healthcare Quality Improvement
  • Health Services Research

Background:

  • Continuous quality improvement (CQI) is widely used in business and engineering.
  • Its application and success in improving nephrology care outcomes are not well-documented.
  • Understanding CQI's impact is crucial for value-based healthcare and reimbursement.

Purpose of the Study:

  • To systematically review the application and success of CQI techniques in nephrology.
  • To identify the extent and effectiveness of CQI in improving nephrology patient outcomes.

Main Methods:

  • A systematic review of CQI applications in nephrology was conducted.
  • Literature search from 2004 to 2014 across multiple databases and grey literature.
  • Studies were evaluated using a systematic protocol with pre-defined criteria by two independent reviewers.

Main Results:

  • Out of 468 initial publications, 76 met criteria for full review; 61% focused on End-Stage Renal Disease (ESRD) care.
  • 74% of studies explicitly mentioned using specific CQI tools.
  • Most studies were published in North America and appeared in biomedical/allied health journals; only one randomized controlled trial was identified.

Conclusions:

  • Few high-quality studies rigorously evaluate CQI's use or best practices in nephrology.
  • Further research is essential to assess CQI's mechanisms and impact on outcomes.
  • Evidence is needed before widespread promotion for improvement and reimbursement.