Quality improvement initiative in paediatric echocardiography laboratory in a low- to middle-income country.
Eur Heart J Qual Care Clin Outcomes
; 8(8): 821-829, 2022 11 17.
Article
em En
| MEDLINE
| ID: mdl-34791116
ABSTRACT
AIMS:
To determine the impact of a quality improvement (QI) initiative in the area of paediatric echocardiography (echo) in a low- to middle-income country (LMIC).Care for patients with congenital heart disease is challenging, especially in LMICs. Collaborative learning through QI projects is imperative to ensure improvement in delivery processes leading to better patient outcomes. METHODS ANDRESULTS:
This QI initiative was taken by a team consisting of physicians and sonographers. Problems were identified, a key driver diagram (KDD) was created, and simple process re-engineering was done using interventions based on the KDD. Metrics (five process and one outcome) were assessed to determine the effectiveness of the QI project. The process metrics assessed were comprehensiveness of exam, timeliness of reporting, diagnostic accuracy and error, and sedation adverse event rates of transthoracic echocardiograms, while a novel comprehensive echo laboratory (lab) quality score was developed as an outcome metric. Data were collected quarterly and analysed in the post-implementation phase. Significant improvement was seen in comprehensive mean score (20.4-29.7), timeliness (40-95%), and diagnostic accuracy rate (91-100%), while a decrease was seen in the diagnostic error rate (7.5-3.5%) and the sedation adverse event rate (6.8-0%), pre- vs. post-implementation. The overall quality outcome score improved from 7 to 19 and the echo lab was able to achieve adequate quality.CONCLUSION:
This QI initiative produced improvement in all the processes, and the overall quality of the echo lab without any substantial increase in resources or cost.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Melhoria de Qualidade
/
Cardiopatias Congênitas
Tipo de estudo:
Prognostic_studies
Limite:
Child
/
Humans
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article