Using a FOCUS-PDCA Quality Improvement Model for Applying the Severe Traumatic Brain Injury Guidelines to Practice: Process and Outcomes

2.50
Hdl Handle:
http://hdl.handle.net/10755/149320
Type:
Presentation
Title:
Using a FOCUS-PDCA Quality Improvement Model for Applying the Severe Traumatic Brain Injury Guidelines to Practice: Process and Outcomes
Abstract:
Using a FOCUS-PDCA Quality Improvement Model for Applying the Severe Traumatic Brain Injury Guidelines to Practice: Process and Outcomes
Conference Sponsor:Sigma Theta Tau International
Conference Year:2001
Conference Date:November 10 - 14, 2001
Author:Bader, Mary
P.I. Institution Name:Mission Hospital Regional Medical Center
Trauma teams strive to provide care based on best practice. Exploring the clinical outcomes of patients sustaining severe traumatic brain injury (TBI) at our trauma center from 1994-1997 we found the outcomes were marginal at best, 43% expiring and 30% suffering severe disability. These results were consistent with some studies on TBI published in the 1980s. Research in the past decade has utilized new technology for monitoring the effects of secondary brain injury and examined the effects of various treatment modalities on the outcomes of TBI patients. In 1995, evidenced based clinical guidelines for managing severe TBI were published recommending changes in the care of these patients. The guidelines challenged hospitals to evaluate their care practices and examine the clinical outcomes of this high-risk group. Motivated by the new practice recommendations and the potential for greatly impacting patient outcomes, MHRMC's multidisciplinary neurotrauma team convened in 1997 to begin the process of performance improvement. Current practice was examined and new hospital based clinical guidelines were developed. Numerous changes were recommended as the team dismantled current practice patterns and constructed new care priorities. The result was a series of algorithms with established outcomes at every phase of the patient's hospital course. Four years after integrating the changes in practice, the team evaluated prospectively collected data to determine outcomes for the severe TBI population. Current outcomes (2001 data) revealed 72.8% of patients achieved a good outcome to moderate disability, 13.6% sustained severe disability to persistent vegetative state, and 13.6% died. This submission will use a FOCUS-PDCA performance improvement approach to demonstrate the processes used to apply national scientific guidelines to the clinical setting. Statistical analysis using an ordinal regression model will provide outcome data emphasizing the positive aspects of applying evidenced based guidelines to practice.
Repository Posting Date:
26-Oct-2011
Date of Publication:
10-Nov-2001
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleUsing a FOCUS-PDCA Quality Improvement Model for Applying the Severe Traumatic Brain Injury Guidelines to Practice: Process and Outcomesen_GB
dc.identifier.urihttp://hdl.handle.net/10755/149320-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Using a FOCUS-PDCA Quality Improvement Model for Applying the Severe Traumatic Brain Injury Guidelines to Practice: Process and Outcomes</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2001</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">November 10 - 14, 2001</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Bader, Mary</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Mission Hospital Regional Medical Center</td></tr><tr><td colspan="2" class="item-abstract">Trauma teams strive to provide care based on best practice. Exploring the clinical outcomes of patients sustaining severe traumatic brain injury (TBI) at our trauma center from 1994-1997 we found the outcomes were marginal at best, 43% expiring and 30% suffering severe disability. These results were consistent with some studies on TBI published in the 1980s. Research in the past decade has utilized new technology for monitoring the effects of secondary brain injury and examined the effects of various treatment modalities on the outcomes of TBI patients. In 1995, evidenced based clinical guidelines for managing severe TBI were published recommending changes in the care of these patients. The guidelines challenged hospitals to evaluate their care practices and examine the clinical outcomes of this high-risk group. Motivated by the new practice recommendations and the potential for greatly impacting patient outcomes, MHRMC's multidisciplinary neurotrauma team convened in 1997 to begin the process of performance improvement. Current practice was examined and new hospital based clinical guidelines were developed. Numerous changes were recommended as the team dismantled current practice patterns and constructed new care priorities. The result was a series of algorithms with established outcomes at every phase of the patient's hospital course. Four years after integrating the changes in practice, the team evaluated prospectively collected data to determine outcomes for the severe TBI population. Current outcomes (2001 data) revealed 72.8% of patients achieved a good outcome to moderate disability, 13.6% sustained severe disability to persistent vegetative state, and 13.6% died. This submission will use a FOCUS-PDCA performance improvement approach to demonstrate the processes used to apply national scientific guidelines to the clinical setting. Statistical analysis using an ordinal regression model will provide outcome data emphasizing the positive aspects of applying evidenced based guidelines to practice.</td></tr></table>en_GB
dc.date.available2011-10-26T10:00:06Z-
dc.date.issued2001-11-10en_GB
dc.date.accessioned2011-10-26T10:00:06Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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