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Changing physicians' behavior using combined strategies and an evidence-based protocol

B A Paes¹, A Modi, R Dunmore

¹Department of Pediatrics, St Joseph's Hospital, Hamilton, Ontario.

Archives of Pediatrics & Adolescent Medicine

|December 1, 1994

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Implementing an evidence-based protocol significantly reduced superficial cultures in neonatal sepsis evaluations, saving costs without harming patients. This quality improvement initiative demonstrates effective change in physician practices for neonatal care.

Area of Science:

Neonatal Medicine
Infectious Diseases
Quality Improvement

Background:

Superficial cultures are often used in neonatal sepsis evaluations.
There is a need to align clinical practices with evidence-based guidelines.

Purpose of the Study:

To assess the impact of an evidence-based protocol on the utilization of superficial cultures for neonatal sepsis.
To evaluate physician compliance with the new protocol.

Main Methods:

A before-and-after medical audit design was employed.
Physician behavior was modified using educational interventions and feedback.
Data were collected on superficial and deep culture usage in 175 newborns post-protocol and 205 newborns pre-protocol.

Main Results:

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The proportion of superficial cultures performed decreased significantly from 50.5% to 6.9%.
A cost saving of $4454.84 was achieved.
No increase in patient morbidity was observed.

Conclusions:

A rigorous reaudit process with interventional strategies can drive practice change in healthcare.
Continuous quality improvement programs are essential for aligning hospital practices with scientific evidence.