Quality improvement - CCDHB
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Recent articles on Quality Improvement in New Zealand
- ANZACS-QI Heart Failure Registry: a new approach using age-stratified sampling of hospital discharges to guide quality improvement (ANZACS-QI 79).This link opens in a new windowJul 25, 2024
Author Names: Chan DZ,Doughty RN,Lund M,Easton A,Poppe KK,Kaur D,Sinclair L,Chirnside J,Malone C,McGrinder H,McLachlan A,Scott J,Roberts J,Wasywich C,Devlin G,Harwood M,Wells S,Harrison W,Kerr AJ
Database Source: Ovid MEDLINE(R)
Journal Title: New Zealand Medical Journal
Year: 2024
Issue: 1599
Volume: 137
Abstract: Heart failure is a major healthcare problem in New Zealand. The Acute Decompensated Heart Failure (ADHF) Registry was introduced in 2015, and has identified the need for quality improvement strategies to improve care of patients hospitalised with heart failure. In this paper, we describe the implementation of the revised ANZACS-QI Heart Failure Registry, which has a primary aim to support evidence-based management of and quality improvement measures for patients who are hospitalised with heart failure in New Zealand. Taking the learnings from the initial experience with the ADHF Registry, the revised ANZACS-QI Heart Failure Registry i) utilises age-stratified sampling of hospital discharge coding to identify a representative heart failure cohort, ii) utilises existing ANZACS-QI infrastructure for data-linkage to reduce the burden of manual data entry, iii) receives governance from the Heart Failure Working Group, and iv) focusses on established quality improvement indicators for heart failure management. Copyright © PMA.
- Raise the Flag I: the impact of a sepsis quality improvement programme on delivery of a sepsis resuscitation bundle at a tertiary hospital in New Zealand.This link opens in a new windowJul 25, 2024
Author Names: Walland KM,Howard C,Paul O,Huggan PJ
Database Source: Ovid MEDLINE(R)
Journal Title: New Zealand Medical Journal
Year: 2023
Issue: 1587
Volume: 136
Abstract: AIMS: To study changes in sepsis resuscitation practice at a tertiary hospital before and after the introduction of a quality improvement programme, and to identify variables associated with its delivery.,METHODS: "Raise the Flag", a quality sepsis programme, including the Sepsis Six, was launched in 2018. Adult patients with sepsis were sampled prior to the intervention and during two subsequent periods.,RESULTS: Clinicians were more likely to deliver the resuscitation bundle in the post-implementation period (adjusted odds ratio [aOR] 2.20, 95% confidence interval [CI] 1.27-3.79, p=0.005). This was not sustained at 18-30 months (aOR 1.22, 95% CI 0.89-1.66, p=0.21). After adjusting for potential confounders, each additional decade of patient age was associated with reduced odds of receiving the bundle (aOR 0.83, 95% CI 0.73-0.95, p=0.005). Admission to intensive care increased in the combined post-implementation periods (aOR 2.81, 95% CI 1.13-6.97, p=0.03).,CONCLUSION: The odds of receiving a resuscitation bundle improved immediately following the launch of the Raise the Flag programme. Resuscitation practice differed based on patient age. Odds of admission to intensive care were increased. Copyright © PMA.
- Audit of antimicrobial stewardship in medical inpatients in Waikato, New Zealand 2021.This link opens in a new windowJul 25, 2024
Author Names: Wong TA,Issa M,Dyer C,Green JK,Tamatea JA,Paoloni G,Hadlow J,McGann H
Database Source: Ovid MEDLINE(R)
Journal Title: New Zealand Medical Journal
Article Title: Audit of antimicrobial stewardship in medical inpatients in Waikato, New Zealand 2021.
Year: 2023
Issue: 1587
Volume: 136
Abstract: AIMS: Given the threat of rising antimicrobial resistance (AMR), 10 audit standards were selected to audit antimicrobial stewardship (AMS) in secondary care to assess guideline adherence and establish quality improvement initiatives in antimicrobial prescribing.,METHODS: Patients were included if they received intravenous (IV) antibiotics across seven medical wards in Waikato or Thames hospitals, New Zealand, in November 2021. Audit standards were defined from the regional antimicrobial prescribing policy and adult antimicrobial guidelines.,RESULTS: In total, 205 patients were audited. Microbiological sampling standards were met in 87 of 126 occasions (69.0%). Antimicrobial choices adhered to guidelines in 89 of 163 patients (54.6%), where guidelines were available. Documentation of antimicrobial indications in the medical notes and antimicrobial review at 48 to 72 hours met the standards at over 90%. Only 2 of 13 patients (15.4%) receiving piperacillin/tazobactam or a carbapenem were discussed with Infectious Diseases (ID). Documentation of indications and durations on paper-based medication charts was infrequent, around 12%. Evaluating for health equity, similar results were observed for Maori and non-Maori.,CONCLUSIONS: Our audit identified specific areas for AMS quality improvement initiatives. Regular audit should become an essential element of the New Zealand AMS strategy. We believe increased AMS resources are required. Copyright © PMA.