Application of quality improvement analytic methodology in emergency medicine research: A comparative evaluation

CJEM
Bruce HarriesRiyad B Abu-Laban

Abstract

Quality improvement (QI) analytic methodology is rarely encountered in the emergency medicine literature. We sought to comparatively apply QI design and analysis techniques to an existing data set, and discuss these techniques as an alternative to standard research methodology for evaluating a change in a process of care. We used data from a previously published randomized controlled trial on triage-nurse initiated radiography using the Ottawa ankle rules (OAR). QI analytic tools were applied to the data set from this study and evaluated comparatively against the original standard research methodology. The original study concluded that triage nurse-initiated radiographs led to a statistically significant decrease in mean emergency department length of stay. Using QI analytic methodology, we applied control charts and interpreted the results using established methods that preserved the time sequence of the data. This analysis found a compelling signal of a positive treatment effect that would have been identified after the enrolment of 58% of the original study sample, and in the 6th month of this 11-month study. Our comparative analysis demonstrates some of the potential benefits of QI analytic methodology. We found that had th...Continue Reading

References

Jan 21, 2011·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Jonathon F ParkinsonKerrie L McDonald
Feb 1, 2011·Public Health·Alex Gatherer, Andrew Fraser

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