Resident-Championed Quality Improvement Provides Value: Confronting Prolonged Mechanical Ventilation.

The Journal of Surgical Research
Adil J MalekHarry T Papaconstantinou

Abstract

The Quality In-Training Initiative (QITI) provides hands-on quality improvement education for residents. As our institution has ranked in the bottom quartile for prolonged mechanical ventilation (PMV) according to the National Surgical Quality Improvement Program (NSQIP), we sought to illustrate how our resident-led QITI could be used to determine perioperative contributors to PMV. The Model for Improvement framework (developed by Associates in Process Improvement) was used to target postoperative ventilator management. However, baseline findings from our 2016 NSQIP data suggested that preoperative patient factors were more likely contributing to PMV. Subsequently, a retrospective one-to-one case-control study was developed, comparing preoperative NSQIP risk calculator profiles for PMV patients to case-matched patients for age, sex, procedure, and emergent case status. Chart review determined ventilator time, 30-d outcomes, and all-cause mortality. Forty-five patients with PMV (69% elective) had a median ventilator time of 134 h (interquartile range 87-254). The NSQIP calculator demonstrated increased preoperative risk percentages in PMV patients when compared to case-matched patients for any complication (includes PMV), predic...Continue Reading

References

Jan 16, 2002·JAMA : the Journal of the American Medical Association·Andrés EstebanUNKNOWN Mechanical Ventilation International Study Group
Jul 9, 2004·Critical Care Medicine·Judith E NelsonR Sean Morrison
Aug 19, 2005·Age and Ageing·Kenneth Rockwood
Jun 22, 2007·Critical Care Medicine·Christopher E CoxGillian D Sanders
Sep 23, 2009·Critical Care Medicine·Christopher E CoxJames A Tulsky
Feb 6, 2010·Critical Care Medicine·Scott K PowersSanford Levine
Nov 26, 2010·Clinics in Geriatric Medicine·Qian-Li Xue
Apr 30, 2013·Journal of the American College of Surgeons·Morgan M SellersKarl Y Bilimoria
Sep 18, 2013·Journal of the American College of Surgeons·Morgan M SellersRachel R Kelz
Feb 22, 2017·Journal of the American College of Surgeons·Mary M MrduttHarry T Papaconstantinou
Oct 26, 2018·Journal of the American College of Surgeons·Ryan HowardDavid Machado-Aranda
Jun 22, 2019·Journal of the American College of Surgeons·Carrie A FosterR Scott Jones
Jul 19, 2019·Annals of Surgery·Maude TrépanierLawrence Lee

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