Quality improvement initiatives in sepsis in an emerging country: does the institution's mainsource of income influence the results? An analysis of 21,103 patients

Detalhes bibliográficos
Autor(a) principal: Machado, Flavia R.
Data de Publicação: 2017
Outros Autores: Ferreira, Elaine M., Sousa, Juliana Lubarino, Silva, Carla, Schippers, Pierre, Pereira, Adriano, Cardoso, Ilusca M., Salomão, Reinaldo, Japiassu, Andre, Akamine, Nelson, Mazza, Bruno F., Assunção, Murillo S. C., Fernandes, Haggeas S., Bossa, Aline, Monteiro, Mariana B., Caixeita, Noemi, Azevedo, Luciano C. P., Silva, Eliezer
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/34439
Resumo: André Japiassu. Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta a informação no documento.
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spelling Machado, Flavia R.Ferreira, Elaine M.Sousa, Juliana LubarinoSilva, CarlaSchippers, PierrePereira, AdrianoCardoso, Ilusca M.Salomão, ReinaldoJapiassu, AndreAkamine, NelsonMazza, Bruno F.Assunção, Murillo S. C.Fernandes, Haggeas S.Bossa, AlineMonteiro, Mariana B.Caixeita, NoemiAzevedo, Luciano C. P.Silva, Eliezer2019-07-26T13:15:21Z2019-07-26T13:15:21Z2017MACHADO, Flavia R. et al. Quality improvement initiatives in sepsis in an emerging country: does the institution's mainsource of income influence the results? An analysis of 21,103 patients. Critical Care Medicine, v. 45, n. 10, p. 1650-1659, Oct. 2017.0090-3493https://www.arca.fiocruz.br/handle/icict/3443910.1097/CCM.00000000000025851530-0293André Japiassu. Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta a informação no documento.2020-07-26Latin American Sepsis Institute. São Paulo, SP, Brazil.Latin American Sepsis Institute. São Paulo, SP, Brazil.Latin American Sepsis Institute. São Paulo, SP, Brazil.Latin American Sepsis Institute. São Paulo, SP, Brazil.Latin American Sepsis Institute. São Paulo, SP, Brazil.Latin American Sepsis Institute. São Paulo, SP, Brazil.Latin American Sepsis Institute. São Paulo, SP, Brazil.Latin American Sepsis Institute. São Paulo, SP, Brazil.Latin American Sepsis Institute. São Paulo, SP, Brazil.Latin American Sepsis Institute. São Paulo, SP, Brazil.Latin American Sepsis Institute. São Paulo, SP, Brazil.Latin American Sepsis Institute. São Paulo, SP, Brazil.Latin American Sepsis Institute. São Paulo, SP, Brazil.Latin American Sepsis Institute. São Paulo, SP, Brazil.Latin American Sepsis Institute. São Paulo, SP, Brazil.Latin American Sepsis Institute. São Paulo, SP, Brazil.Latin American Sepsis Institute. São Paulo, SP, Brazil.Latin American Sepsis Institute. São Paulo, SP, Brazil.Objective: We aimed to assess the results of a quality improvement initiative in sepsis in an emerging setting and to analyze it according to the institutions’ main source of income (public or private). Design: Retrospective analysis of the Latin American Sepsis Institute database from 2005 to 2014. Settings: Brazilian public and private institutions. Patients: Patients with sepsis admitted in the participant institutions. Interventions: The quality improvement initiative was based on a multifaceted intervention. The institutions were instructed to collect data on 6-hour bundle compliance and outcomes in patients with sepsis in all hospital settings. Outcomes and compliance was measured for eight periods of 6 months each, starting at the time of the enrollment in the intervention. The primary outcomes were hospital mortality and compliance with 6-hour bundle. Measurements and Main Results: We included 21,103 patients; 9,032 from public institutions and 12,071 from private institutions. Comparing the first period with the eigth period, compliance with the 6-hour bundle increased from 13.5% to 58.2% in the private institutions (p < 0.0001) and from 7.4% to 15.7% in the public institutions (p < 0.0001). Mortality rates significantly decreased throughout the program in private institutions, from 47.6% to 27.2% in the eighth period (adjusted odds ratio, 0.45; 95% CI, 0.32–0.64). However, in the public hospitals, mortality diminished significantly only in the first two periods. Conclusion: This quality improvement initiative in sepsis in an emerging country was associated with a reduction in mortality and with improved compliance with quality indicators. However, this reduction was sustained only in private institutions.engLippincott, Williams & WilkinsQuality improvement initiatives in sepsis in an emerging country: does the institution's mainsource of income influence the results? 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dc.title.pt_BR.fl_str_mv Quality improvement initiatives in sepsis in an emerging country: does the institution's mainsource of income influence the results? An analysis of 21,103 patients
title Quality improvement initiatives in sepsis in an emerging country: does the institution's mainsource of income influence the results? An analysis of 21,103 patients
spellingShingle Quality improvement initiatives in sepsis in an emerging country: does the institution's mainsource of income influence the results? An analysis of 21,103 patients
Machado, Flavia R.
Mortality
Sepsis bundles
Sepsis
Septic shock
Quality improvement
title_short Quality improvement initiatives in sepsis in an emerging country: does the institution's mainsource of income influence the results? An analysis of 21,103 patients
title_full Quality improvement initiatives in sepsis in an emerging country: does the institution's mainsource of income influence the results? An analysis of 21,103 patients
title_fullStr Quality improvement initiatives in sepsis in an emerging country: does the institution's mainsource of income influence the results? An analysis of 21,103 patients
title_full_unstemmed Quality improvement initiatives in sepsis in an emerging country: does the institution's mainsource of income influence the results? An analysis of 21,103 patients
title_sort Quality improvement initiatives in sepsis in an emerging country: does the institution's mainsource of income influence the results? An analysis of 21,103 patients
author Machado, Flavia R.
author_facet Machado, Flavia R.
Ferreira, Elaine M.
Sousa, Juliana Lubarino
Silva, Carla
Schippers, Pierre
Pereira, Adriano
Cardoso, Ilusca M.
Salomão, Reinaldo
Japiassu, Andre
Akamine, Nelson
Mazza, Bruno F.
Assunção, Murillo S. C.
Fernandes, Haggeas S.
Bossa, Aline
Monteiro, Mariana B.
Caixeita, Noemi
Azevedo, Luciano C. P.
Silva, Eliezer
author_role author
author2 Ferreira, Elaine M.
Sousa, Juliana Lubarino
Silva, Carla
Schippers, Pierre
Pereira, Adriano
Cardoso, Ilusca M.
Salomão, Reinaldo
Japiassu, Andre
Akamine, Nelson
Mazza, Bruno F.
Assunção, Murillo S. C.
Fernandes, Haggeas S.
Bossa, Aline
Monteiro, Mariana B.
Caixeita, Noemi
Azevedo, Luciano C. P.
Silva, Eliezer
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Machado, Flavia R.
Ferreira, Elaine M.
Sousa, Juliana Lubarino
Silva, Carla
Schippers, Pierre
Pereira, Adriano
Cardoso, Ilusca M.
Salomão, Reinaldo
Japiassu, Andre
Akamine, Nelson
Mazza, Bruno F.
Assunção, Murillo S. C.
Fernandes, Haggeas S.
Bossa, Aline
Monteiro, Mariana B.
Caixeita, Noemi
Azevedo, Luciano C. P.
Silva, Eliezer
dc.subject.en.pt_BR.fl_str_mv Mortality
Sepsis bundles
Sepsis
Septic shock
Quality improvement
topic Mortality
Sepsis bundles
Sepsis
Septic shock
Quality improvement
description André Japiassu. Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta a informação no documento.
publishDate 2017
dc.date.issued.fl_str_mv 2017
dc.date.accessioned.fl_str_mv 2019-07-26T13:15:21Z
dc.date.available.fl_str_mv 2019-07-26T13:15:21Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv MACHADO, Flavia R. et al. Quality improvement initiatives in sepsis in an emerging country: does the institution's mainsource of income influence the results? An analysis of 21,103 patients. Critical Care Medicine, v. 45, n. 10, p. 1650-1659, Oct. 2017.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/34439
dc.identifier.issn.pt_BR.fl_str_mv 0090-3493
dc.identifier.doi.none.fl_str_mv 10.1097/CCM.0000000000002585
dc.identifier.eissn.none.fl_str_mv 1530-0293
identifier_str_mv MACHADO, Flavia R. et al. Quality improvement initiatives in sepsis in an emerging country: does the institution's mainsource of income influence the results? An analysis of 21,103 patients. Critical Care Medicine, v. 45, n. 10, p. 1650-1659, Oct. 2017.
0090-3493
10.1097/CCM.0000000000002585
1530-0293
url https://www.arca.fiocruz.br/handle/icict/34439
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Lippincott, Williams & Wilkins
publisher.none.fl_str_mv Lippincott, Williams & Wilkins
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
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