Effect of Audit and Feedback on Physician Adherence to Clinical Practice Guidelines for Pneumonia and Sepsis

被引：13

作者：

Trent, Stacy A. ^{[1
,2
]}

Havranek, Edward P. ^{[1
,2
]}

Ginde, Adit A. ^{[2
,3
]}

Haukoos, Jason S. ^{[1
,2
,3
]}

机构：

[1] Denver Hlth Med Ctr, Denver, CO USA

[2] Univ Colorado, Aurora, CO USA

[3] Colorado Sch Publ Hlth, Aurora, CO USA

来源：

AMERICAN JOURNAL OF MEDICAL QUALITY | 2019年 / 34卷 / 03期

关键词：

guideline adherence; feedback; peer comparison; emergency medicine; infectious disease; GOAL-DIRECTED RESUSCITATION; QUALITY IMPROVEMENT; MANAGEMENT; BUNDLE; CARE; IMPLEMENTATION; MORTALITY; CAMPAIGN; OUTCOMES; TRIALS;

D O I：

10.1177/1062860618796947

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

The objective was to estimate the effect of feedback with blinded peer comparison on emergency physician adherence to guidelines for appropriate antibiotic administration for inpatient pneumonia and completion of the 3-hour Surviving Sepsis Bundle for severe sepsis. The authors performed a quasi-experiment using a stepped wedge design at a single urban safety net hospital. Attending emergency physicians were randomized into 6 clusters. Once a cluster crossed into the intervention group, physicians in that cluster began receiving detailed feedback with blinded peer comparison on their adherence to guidelines for pneumonia and sepsis. Feedback with blinded peer comparison significantly improved guideline adherence from 52% without feedback to 65% with feedback (difference = 13%, 95% confidence interval = 4% to 22%). In adjusted analyses, the odds of providing guideline adherent care were 1.8 (95% confidence interval = 1.01-3.2) after the introduction of feedback with blinded peer comparison. Feedback with blinded peer comparison significantly improved emergency physician guideline adherence.

引用

页码：217 / 225

页数：9

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