Journal ArticleDOI
Systematic review of the application of quality improvement methodologies from the manufacturing industry to surgical healthcare.
Christopher R. Nicolay,Sanjay Purkayastha,A Greenhalgh,Jonathan Benn,Sankalp Chaturvedi,Nelson Phillips,Ara Darzi +6 more
TLDR
The aim of this systematic review was to identify and evaluate the application and effectiveness of quality improvement methodologies to the field of surgery.Abstract:
Background:
The demand for the highest-quality patient care coupled with pressure on funding has led to the increasing use of quality improvement (QI) methodologies from the manufacturing industry. The aim of this systematic review was to identify and evaluate the application and effectiveness of these QI methodologies to the field of surgery.
Methods:
MEDLINE, the Cochrane Database, Allied and Complementary Medicine Database, British Nursing Index, Cumulative Index to Nursing and Allied Health Literature, Embase, Health Business™ Elite, the Health Management Information Consortium and PsycINFO® were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Empirical studies were included that implemented a described QI methodology to surgical care and analysed a named outcome statistically.
Results:
Some 34 of 1595 articles identified met the inclusion criteria after consensus from two independent investigators. Nine studies described continuous quality improvement (CQI), five Six Sigma, five total quality management (TQM), five plan-do-study-act (PDSA) or plan-do-check-act (PDCA) cycles, five statistical process control (SPC) or statistical quality control (SQC), four Lean and one Lean Six Sigma; 20 of the studies were undertaken in the USA. The most common aims were to reduce complications or improve outcomes (11), to reduce infection (7), and to reduce theatre delays (7). There was one randomized controlled trial.
Conclusion:
QI methodologies from industry can have significant effects on improving surgical care, from reducing infection rates to increasing operating room efficiency. The evidence is generally of suboptimal quality, and rigorous randomized multicentre studies are needed to bring evidence-based management into the same league as evidence-based medicine. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.read more
Citations
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Journal ArticleDOI
Systematic review of the application of the plan–do–study–act method to improve quality in healthcare
TL;DR: A theoretical framework for assessing the quality of application of PDSA cycles is proposed and the consistency with which the method has been applied in peer-reviewed literature against this framework is explored.
Journal ArticleDOI
Lean in healthcare: A comprehensive review
TL;DR: Even though Lean results appear to be promising, findings so far do not allow to draw a final word on its positive impacts or challenges when introduced in the healthcare sector.
Journal ArticleDOI
The use of Lean and Six Sigma methodologies in surgery: A systematic review
TL;DR: Lean and Six Sigma QI methodologies have the potential to produce clinically significant improvement for surgical patients, however there is a need to conduct high-quality studies with low risk of systematic bias in order to further understand their role.
Journal ArticleDOI
Readiness of US General Surgery Residents for Independent Practice
Brian C. George,Jordan D. Bohnen,Reed G. Williams,Shari L. Meyerson,Mary C. Schuller,Michael Clark,Andreas H. Meier,Laura Torbeck,Samuel P. Mandell,John T. Mullen,Douglas S. Smink,Rebecca E. Scully,Jeffrey G. Chipman,Edward D. Auyang,Kyla P. Terhune,Paul E. Wise,Jennifer N. Choi,Eugene F. Foley,Justin B. Dimick,Michael A. Choti,Nathaniel J. Soper,Keith D. Lillemoe,Joseph B. Zwischenberger,Gary L. Dunnington,Debra A. DaRosa,Jonathan P. Fryer +25 more
TL;DR: US General Surgery residents are not universally ready to independently perform Core procedures by the time they complete residency training, and it is unknown if the amount of autonomy residents do achieve is sufficient to ensure readiness for the entire spectrum of independent practice.
Journal ArticleDOI
Does quality improvement improve quality
Mary Dixon-Woods,Graham Martin +1 more
TL;DR: This article proposes four key ways in which quality improvement might itself be improved, and considers the challenges faced by QI as a way of addressing the problems with healthcare.
References
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BookDOI
To Err Is Human Building a Safer Health System
TL;DR: Boken presenterer en helhetlig strategi for hvordan myndigheter, helsepersonell, industri og forbrukere kan redusere medisinske feil.
Journal ArticleDOI
The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration
Alessandro Liberati,Douglas G. Altman,Jennifer Tetzlaff,Cynthia D. Mulrow,Peter C Gøtzsche,John P. A. Ioannidis,Mike Clarke,Philip J. Devereaux,Jos Kleijnen,David Moher +9 more
TL;DR: The meaning and rationale for each checklist item is explained, and an example of good reporting is included and, where possible, references to relevant empirical studies and methodological literature are included.
Journal ArticleDOI
The quality of health care delivered to adults in the United States.
Elizabeth A. McGlynn,Steven M. Asch,John L. Adams,Joan Keesey,Jennifer Hicks,Alison H. DeCristofaro,Eve A. Kerr +6 more
TL;DR: The deficits the authors have identified in adherence to recommended processes for basic care pose serious threats to the health of the American public and strategies to reduce these deficits in care are warranted.
Journal ArticleDOI
Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews
Beverley Shea,Jeremy M. Grimshaw,George A. Wells,Maarten Boers,Neil Andersson,Candyce Hamel,Ashley C Porter,Peter Tugwell,David Moher,Lex M. Bouter +9 more
TL;DR: A measurement tool for the 'assessment of multiple systematic reviews' (AMSTAR) was developed that consists of 11 items and has good face and content validity for measuring the methodological quality of systematic reviews.
Journal ArticleDOI
To err is human. Building a safer health system
TL;DR: The IOM report “To Err is Human” proposes an approach for reducing medical errors and improving patient safety by designing processes that are able to ensure that patients are safe from accidental injury.