1st successful national CQI intervention in medicine reported

New OrleansT. Bruce Ferguson, Jr., MD, Professor of Surgery and Physiology at Louisiana State University Health Sciences Center in New Orleans, is the lead author of a paper being published in the July 2, 2003 issue of the JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION that reports the success of the first randomized trial of Continuous Quality Improvement (CQI) accomplished on a national scale. The researchers found that a physician-led, low-intensity CQI intervention could have demonstrable impact on local coronary artery bypass grafting (CABG) care practices within a two-year period. The researchers believe that the results demonstrate the potential for medical specialty societies to have a major impact on the national adoption of important care processes into clinical practice.

Adapted from industrial manufacturing principles in Japan and the United States, CQI in medicine is the repetitive cycle of process and outcomes measurement, design and implementation of interventions to improve the processes of care, and re-measurement to determine the effect on care quality. To date, successful CQI programs in medicine have been difficult to achieve due to a lack of appropriate information technology and organizational infrastructure.

This study utilized data from 359 hospitals participating in the Society of Thoracic Surgeons National Cardiac Database, funded by a grant from the Agency for Healthcare Research and Quality. Results were assessed among a total of 267,917 patients.

The objective of the study was to test whether low-intensity CQI interventions can be used to speed the national adoption of two coronary artery bypass grafting processes. Hospitals were prospectively randomized to receive one of two interventions designed to increase use of either preoperative beta-blocker therapy or IMA grafting in patients older than 75 years, or to a control group with no intervention. Preoperative beta-blocker therapy was chosen because of its p

Contact: Leslie Capo
Louisiana State University Health Science Center

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