Impact of modified quality control checklist on protocol adherence and outcomes in a post-surgical Intensive Care
Lakshmi Kumar1, Meenu Dominic2, Sunil Rajan1
1Department of Anaesthesiology and Critical Care, Amrita Institute of Medical Sciences (Amrita Vishwa Vidyapeetham), Kochi, Kerala, India.
Background And Aims:
Quality improvement (QI) is the sum of all activities that create desired changes in the quality. An effective QI system results in a stepwise increase in quality of care. The efficiency of any health-care unit is judged by its quality indicators. We aimed to evaluate the impact of QI initiatives on outcomes in a surgical Intensive Care Unit (ICU).
Methods:
This was an observational study carried out using a compliance checklist, developed from the combination of the World Health Organization surgery checklist and Society for Healthcare Epidemiology of America guidelines for the prevention of infections. A total of 170 patients were prospectively evaluated for adherence to the checklist and occurrence of infections. This was compared with a random retrospective analysis of 170 patients who had undergone similar surgeries in the previous 3 months.
Results:
Introduction and supervised documentation of comprehensive checklist brought out significant improvement in the documentation of quality indicators (98% vs. 32%) in the prospective samples. There was no difference in mortality, health-care-related infection rates or length of ICU stay.
Conclusion:
The introduction of comprehensive surgical checklist improved documentation of parameters for quality control but did not decrease the rates of infection in comparison to the control sample.
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