Effectiveness of a quality improvement collaborative in reducing time to surgery for patients requiring emergency cholecystectomy

Background Acute gallstone disease is a high‐volume emergency general surgery presentation with wide variations in the quality of care provided across the UK. This controlled cohort evaluation assessed whether participation in a quality improvement collaborative approach reduced time to surgery for...

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Main Authors: J. R. Bamber, T. J. Stephens, D. A. Cromwell, E. Duncan, G. P. Martin, N. F. Quiney, J. F. Abercrombie, I. J. Beckingham, on behalf of the Cholecystectomy Quality Improvement Collaborative
Format: Article
Language:English
Published: Oxford University Press 2019-12-01
Series:BJS Open
Online Access:https://doi.org/10.1002/bjs5.50221
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spelling doaj-f514ee651727445a8cf3cdaa9e2bf6822021-04-02T05:43:01ZengOxford University PressBJS Open2474-98422019-12-013680281110.1002/bjs5.50221Effectiveness of a quality improvement collaborative in reducing time to surgery for patients requiring emergency cholecystectomyJ. R. Bamber0T. J. Stephens1D. A. Cromwell2E. Duncan3G. P. Martin4N. F. Quiney5J. F. Abercrombie6I. J. Beckingham7on behalf of the Cholecystectomy Quality Improvement CollaborativePracticality Consulting Queen Mary University of London London UKWilliam Harvey Research Institute Queen Mary University of London London UKDepartment of Health Services Research and Policy London School of Hygiene and Tropical Medicine London UKDepartment of Professional Standards Royal College of Surgeons of England London UKThe Healthcare Improvement Studies (THIS) Institute University of Cambridge Cambridge UKDepartment of Anaesthesia Royal Surrey County Hospital Guildford UKDepartments of Colorectal Surgery Queen's Medical Centre Nottingham UKHepatobiliary and Pancreatic Surgery Queen's Medical Centre Nottingham UKBackground Acute gallstone disease is a high‐volume emergency general surgery presentation with wide variations in the quality of care provided across the UK. This controlled cohort evaluation assessed whether participation in a quality improvement collaborative approach reduced time to surgery for patients with acute gallstone disease to fewer than 8 days from presentation, in line with national guidance. Methods Patients admitted to hospital with acute biliary conditions in England and Wales between 1 April 2014 and 31 December 2017 were identified from Hospital Episode Statistics data. Time series of quarterly activity were produced for the Cholecystectomy Quality Improvement Collaborative (Chole‐QuIC) and all other acute National Health Service hospitals (control group). A negative binomial regression model was used to compare the proportion of patients having surgery within 8 days in the baseline and intervention periods. Results Of 13 sites invited to join Chole‐QuIC, 12 participated throughout the collaborative, which ran from October 2016 to January 2018. Of 7944 admissions, 1160 patients had a cholecystectomy within 8 days of admission, a significant improvement (P < 0·050) from baseline performance. This represented a relative change of 1·56 (95 per cent c.i. 1·38 to 1·75), compared with 1·08 for the control group. At the individual site level, eight of the 12 Chole‐QuIC sites showed a significant improvement (P < 0·050), with four sites increasing their 8‐day surgery rate to over 20 per cent of all emergency admissions, well above the mean of 15·3 per cent for control hospitals. Conclusion A surgeon‐led quality improvement collaborative approach improved care for patients requiring emergency cholecystectomy.https://doi.org/10.1002/bjs5.50221
collection DOAJ
language English
format Article
sources DOAJ
author J. R. Bamber
T. J. Stephens
D. A. Cromwell
E. Duncan
G. P. Martin
N. F. Quiney
J. F. Abercrombie
I. J. Beckingham
on behalf of the Cholecystectomy Quality Improvement Collaborative
spellingShingle J. R. Bamber
T. J. Stephens
D. A. Cromwell
E. Duncan
G. P. Martin
N. F. Quiney
J. F. Abercrombie
I. J. Beckingham
on behalf of the Cholecystectomy Quality Improvement Collaborative
Effectiveness of a quality improvement collaborative in reducing time to surgery for patients requiring emergency cholecystectomy
BJS Open
author_facet J. R. Bamber
T. J. Stephens
D. A. Cromwell
E. Duncan
G. P. Martin
N. F. Quiney
J. F. Abercrombie
I. J. Beckingham
on behalf of the Cholecystectomy Quality Improvement Collaborative
author_sort J. R. Bamber
title Effectiveness of a quality improvement collaborative in reducing time to surgery for patients requiring emergency cholecystectomy
title_short Effectiveness of a quality improvement collaborative in reducing time to surgery for patients requiring emergency cholecystectomy
title_full Effectiveness of a quality improvement collaborative in reducing time to surgery for patients requiring emergency cholecystectomy
title_fullStr Effectiveness of a quality improvement collaborative in reducing time to surgery for patients requiring emergency cholecystectomy
title_full_unstemmed Effectiveness of a quality improvement collaborative in reducing time to surgery for patients requiring emergency cholecystectomy
title_sort effectiveness of a quality improvement collaborative in reducing time to surgery for patients requiring emergency cholecystectomy
publisher Oxford University Press
series BJS Open
issn 2474-9842
publishDate 2019-12-01
description Background Acute gallstone disease is a high‐volume emergency general surgery presentation with wide variations in the quality of care provided across the UK. This controlled cohort evaluation assessed whether participation in a quality improvement collaborative approach reduced time to surgery for patients with acute gallstone disease to fewer than 8 days from presentation, in line with national guidance. Methods Patients admitted to hospital with acute biliary conditions in England and Wales between 1 April 2014 and 31 December 2017 were identified from Hospital Episode Statistics data. Time series of quarterly activity were produced for the Cholecystectomy Quality Improvement Collaborative (Chole‐QuIC) and all other acute National Health Service hospitals (control group). A negative binomial regression model was used to compare the proportion of patients having surgery within 8 days in the baseline and intervention periods. Results Of 13 sites invited to join Chole‐QuIC, 12 participated throughout the collaborative, which ran from October 2016 to January 2018. Of 7944 admissions, 1160 patients had a cholecystectomy within 8 days of admission, a significant improvement (P < 0·050) from baseline performance. This represented a relative change of 1·56 (95 per cent c.i. 1·38 to 1·75), compared with 1·08 for the control group. At the individual site level, eight of the 12 Chole‐QuIC sites showed a significant improvement (P < 0·050), with four sites increasing their 8‐day surgery rate to over 20 per cent of all emergency admissions, well above the mean of 15·3 per cent for control hospitals. Conclusion A surgeon‐led quality improvement collaborative approach improved care for patients requiring emergency cholecystectomy.
url https://doi.org/10.1002/bjs5.50221
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