Antenatal magnesium sulfate to prevent cerebral palsy

2021 ◽  
pp. fetalneonatal-2021-321817
Author(s):  
Amy K Keir ◽  
Emily Shepherd ◽  
Sarah McIntyre ◽  
Alice Rumbold ◽  
Charlotte Groves ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Quality Improvement ◽  
Magnesium Sulfate ◽  
Perinatal Care ◽  
Quality Improvement Programme ◽  
Baseline Rate ◽  
Local Quality ◽  
Improvement Programme ◽  
The Impact

Magnesium sulfate given to women before birth at <30 weeks’ gestation reduces the risk of cerebral palsy in their children. Our study aimed to assess the impact of a local quality improvement programme, primarily using plan-do-study-act cycles, to increase the use of antenatal magnesium sulfate. After implementing our quality improvement programme, an average of 86% of babies delivered at <30 weeks’ gestation were exposed to antenatal magnesium sulfate compared with a historical baseline rate of 63%. Our study strengthens the case for embedding quality improvement programmes in maternal perinatal care to reduce the impact of cerebral palsy on families and society.

scholarly journals Impact and feasibility of a tailor-made patient communication quality improvement programme for hospital-based physiotherapists: a mixed-methods study

2021 ◽  
Vol 10 (2) ◽  
pp. e001286
Author(s):  
Rudi A Steenbruggen ◽  
Linda AG van Heusden-Scholtalbers ◽  
Thomas J Hoogeboom ◽  
Marjo Maas ◽  
Paul Brand ◽  
...  
Keyword(s):  
Professional Development ◽  
Quality Improvement ◽  
Mixed Methods ◽  
Patient Communication ◽  
Mixed Methods Study ◽  
Barriers And Facilitators ◽  
Added Value ◽  
Quality Improvement Programme ◽  
Improvement Programme ◽  
The Impact

BackgroundIn tailoring a quality improvement programme for hospital-based physiotherapy, the original use of video recordings was replaced by using the tracer methodology.ObjectiveTo examine the impact of a tailor-made quality improvement programme addressing patient communication on the professional development of hospital-based physiotherapists, and to evaluate barriers and facilitators as determinants of feasibility of the programme.MethodsA mixed-methods study was conducted. Participants were clustered in groups per hospital and linked with an equally sized group in a nearby hospital. Within the groups, fixed couples carried out a 2-hour tracer by directly observing each other’s daily work routine. This procedure was repeated 6 months later. Data from feedback forms were analysed quantitatively, and a thematic analysis of transcripts from group interviews was conducted.ResultsFifty hospital-based physiotherapists from 16 hospitals participated. They rated the impact of the programme on professional development, on a scale from 1 (much improvement needed) to 5 (no improvement needed), as 3.99 (SD 0.64) after the first tracer and 4.32 (SD 0.63) 6 months later; a mean improvement of 0.33 (95% CI 0.16 to 0.50). Participants scored, on a scale ranging from 1 to 5 on barriers and facilitators (feasibility), a mean of 3.45 (SD 0.95) on determinants of innovation, 3.47 (SD 0.86) on probability to use and 2.63 (SD 1.07) on the user feedback list. All participants emphasised the added value of the tracer methodology and mentioned effects on self-reflection and awareness most.ConclusionsThe tailor-made quality improvement programme, based on principles of the tracer methodology, was associated with a significant impact on professional development. Barriers and facilitators as determinants of feasibility of the programme showed the programme being feasible.

scholarly journals Each baby counts: National quality improvement programme to reduce intrapartum-related deaths and brain injuries in term babies

2017 ◽  
Vol 22 (3) ◽  
pp. 193-198 ◽  
Author(s):  
Louise Robertson ◽  
Hannah Knight ◽  
Edward Prosser Snelling ◽  
Emily Petch ◽  
Marian Knight ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Brain Injuries ◽  
Quality Improvement Programme ◽  
National Quality ◽  
Improvement Programme

scholarly journals Identifying effective pathways in a successful continuous quality improvement programme: the GEDAPS study

2014 ◽  
Vol 20 (6) ◽  
pp. 1137-1143 ◽  
Author(s):  
Danielle H. Bodicoat ◽  
Xavier Mundet ◽  
Laura J. Gray ◽  
Xavier Cos ◽  
Melanie J. Davies ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Continuous Quality Improvement ◽  
Quality Improvement Programme ◽  
Continuous Quality ◽  
Improvement Programme

A quality improvement programme to reduce pressure ulcers

2015 ◽  
Vol 29 (46) ◽  
pp. 62-70 ◽  
Author(s):  
Nicola Heywood ◽  
Lisa Brown ◽  
Michaela Arrowsmith ◽  
Alexa Poppleston
Keyword(s):  
Quality Improvement ◽  
Pressure Ulcers ◽  
Quality Improvement Programme ◽  
Improvement Programme

Effect of a health system payment and quality improvement programme for tonsillectomy in Ontario, Canada: an interrupted time series analysis

2021 ◽  
pp. bmjqs-2021-013110
Author(s):  
Sanjay Mahant ◽  
Jun Guan ◽  
Jessie Zhang ◽  
Sima Gandhi ◽  
Evan Jon Propst ◽  
...  
Keyword(s):  
Time Series ◽  
Quality Improvement ◽  
Quality Of Care ◽  
Health System ◽  
Interrupted Time Series ◽  
Improve Quality ◽  
Interrupted Time Series Analysis ◽  
Quality Improvement Programme ◽  
Improvement Programme

BackgroundTonsillectomy is among the most common and cumulatively expensive surgical procedures in children, with known variations in quality of care. However, evidence on health system interventions to improve quality of care is limited. The Quality-Based Procedures (QBP) programme in Ontario, Canada, introduced fixed episode hospital payment per tonsillectomy and disseminated a perioperative care pathway. We determined the association of this payment and quality improvement programme with tonsillectomy quality of care.MethodsInterrupted time series analysis of children undergoing elective tonsillectomy at community and children’s hospitals in Ontario in the QBP period (1 April 2014 to 31 December 2018) and the pre-QBP period (1 January 2009 to 31 January 2014) using health administrative data. We compared the age-standardised and sex-standardised rates for all-cause tonsillectomy-related revisits within 30 days, opioid prescription fills within 30 days and index tonsillectomy inpatient admission.Results111 411 children underwent tonsillectomy: 51 967 in the QBP period and 59 444 in the pre-QBP period (annual median number of hospitals, 86 (range 77–93)). Following QBP programme implementation, revisit rates decreased for all-cause tonsillectomy-related revisits (0.48 to −0.18 revisits per 1000 tonsillectomies per month; difference −0.66 revisits per 1000 tonsillectomies per month (95% CI −0.97 to −0.34); p<0.0001). Codeine prescription fill rate continued to decrease but at a slower rate (−4.81 to −0.11 prescriptions per 1000 tonsillectomies per month; difference 4.69 (95% CI 3.60 to 5.79) prescriptions per 1000 tonsillectomies per month; p<0.0001). The index tonsillectomy inpatient admission rate decreased (1.12 to 0.23 admissions per 1000 tonsillectomies per month; difference −0.89 (95% CI −1.33 to −0.44) admissions per 1000 tonsillectomies per month; p<0.0001).ConclusionsThe payment and quality improvement programme was associated with several improvements in quality of care. These findings may inform jurisdictions planning health system interventions to improve quality of care for tonsillectomy and other paediatric procedures.

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