Improving Blood Pressure Management and Disease Severity Documentation in Patients With Acute Intracerebral Hemorrhage
Objective: To ensure prime blood pressure management and intracerebral hemorrhage (ICH) score documentation within 6 hours of arrival and/or before any intervention in patients admitted to Mayo Clinic Hospital with acute ICH. Patients and Methods: A quality improvement initiative was conducted betwe...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2017-12-01
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| Series: | Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2542454817300437 |
| _version_ | 1818991792552411136 |
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| author | Oana M. Dumitrascu, MD, MS Cumara B. O'Carroll, MD, MPH Vanesa Vanderhye, BSN Bart M. Demaerschalk, MD, MSc Maria I. Aguilar, MD |
| author_facet | Oana M. Dumitrascu, MD, MS Cumara B. O'Carroll, MD, MPH Vanesa Vanderhye, BSN Bart M. Demaerschalk, MD, MSc Maria I. Aguilar, MD |
| author_sort | Oana M. Dumitrascu, MD, MS |
| collection | DOAJ |
| description | Objective: To ensure prime blood pressure management and intracerebral hemorrhage (ICH) score documentation within 6 hours of arrival and/or before any intervention in patients admitted to Mayo Clinic Hospital with acute ICH. Patients and Methods: A quality improvement initiative was conducted between September 29, 2015, and May 30, 2017, following the Define-Measure-Analyze-Improve-Control methodology. Our prespecified goals for the first 8 months postintervention were that at least 80% of patients with ICH will have systolic blood pressure (SBP) control as per guideline-based recommendations (SBP ≤140 mm Hg) and at least 80% will have ICH score documented within 6 hours postadmission. Neurovascular stakeholders' feedback was included in the process development. Practice gaps and their leading causes were identified and served rational interventions' planning. Education and admission order-set modifications were chosen as intervention methods. Results: At 4 (first measurement, n=13) and 8 months (second measurement, n=15) postintervention, 92.3% and 100% of patients with ICH, respectively, reached the target SBP, compared with 50% in the preintervention group (comparison group, n=26); 84.6% and 85.7% of the patient population had the ICH score documented at the first and second outcome measurement, respectively, compared with 42.3% in the preintervention group. Stakeholders reported good satisfaction with the novel applications. Sustainability plans and future directions were established. Conclusion: Effective education methods enhance the introduction of guideline-based clinical practices. This quality improvement project has the potential to impact patient outcomes, staff efficiency, and stroke centers' maintenance of certification and quality care recognition. This initiative warrants implementation at hospitals across all Mayo Clinic campuses and nationwide. |
| first_indexed | 2024-12-20T20:15:54Z |
| format | Article |
| id | doaj.art-59c8329f042248a2a679a26b759611e2 |
| institution | Directory Open Access Journal |
| issn | 2542-4548 |
| language | English |
| last_indexed | 2024-12-20T20:15:54Z |
| publishDate | 2017-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
| spelling | doaj.art-59c8329f042248a2a679a26b759611e22022-12-21T19:27:43ZengElsevierMayo Clinic Proceedings: Innovations, Quality & Outcomes2542-45482017-12-0113219225Improving Blood Pressure Management and Disease Severity Documentation in Patients With Acute Intracerebral HemorrhageOana M. Dumitrascu, MD, MS0Cumara B. O'Carroll, MD, MPH1Vanesa Vanderhye, BSN2Bart M. Demaerschalk, MD, MSc3Maria I. Aguilar, MD4Correspondence: Address to Oana M. Dumitrascu, MD, MS, Department of Neurology, Mayo Clinic, 5777 East Mayo Blvd, Phoenix, AZ 85054.; Department of Neurology, Mayo Clinic, Phoenix, AZDepartment of Neurology, Mayo Clinic, Phoenix, AZDepartment of Neurology, Mayo Clinic, Phoenix, AZDepartment of Neurology, Mayo Clinic, Phoenix, AZDepartment of Neurology, Mayo Clinic, Phoenix, AZObjective: To ensure prime blood pressure management and intracerebral hemorrhage (ICH) score documentation within 6 hours of arrival and/or before any intervention in patients admitted to Mayo Clinic Hospital with acute ICH. Patients and Methods: A quality improvement initiative was conducted between September 29, 2015, and May 30, 2017, following the Define-Measure-Analyze-Improve-Control methodology. Our prespecified goals for the first 8 months postintervention were that at least 80% of patients with ICH will have systolic blood pressure (SBP) control as per guideline-based recommendations (SBP ≤140 mm Hg) and at least 80% will have ICH score documented within 6 hours postadmission. Neurovascular stakeholders' feedback was included in the process development. Practice gaps and their leading causes were identified and served rational interventions' planning. Education and admission order-set modifications were chosen as intervention methods. Results: At 4 (first measurement, n=13) and 8 months (second measurement, n=15) postintervention, 92.3% and 100% of patients with ICH, respectively, reached the target SBP, compared with 50% in the preintervention group (comparison group, n=26); 84.6% and 85.7% of the patient population had the ICH score documented at the first and second outcome measurement, respectively, compared with 42.3% in the preintervention group. Stakeholders reported good satisfaction with the novel applications. Sustainability plans and future directions were established. Conclusion: Effective education methods enhance the introduction of guideline-based clinical practices. This quality improvement project has the potential to impact patient outcomes, staff efficiency, and stroke centers' maintenance of certification and quality care recognition. This initiative warrants implementation at hospitals across all Mayo Clinic campuses and nationwide.http://www.sciencedirect.com/science/article/pii/S2542454817300437 |
| spellingShingle | Oana M. Dumitrascu, MD, MS Cumara B. O'Carroll, MD, MPH Vanesa Vanderhye, BSN Bart M. Demaerschalk, MD, MSc Maria I. Aguilar, MD Improving Blood Pressure Management and Disease Severity Documentation in Patients With Acute Intracerebral Hemorrhage Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
| title | Improving Blood Pressure Management and Disease Severity Documentation in Patients With Acute Intracerebral Hemorrhage |
| title_full | Improving Blood Pressure Management and Disease Severity Documentation in Patients With Acute Intracerebral Hemorrhage |
| title_fullStr | Improving Blood Pressure Management and Disease Severity Documentation in Patients With Acute Intracerebral Hemorrhage |
| title_full_unstemmed | Improving Blood Pressure Management and Disease Severity Documentation in Patients With Acute Intracerebral Hemorrhage |
| title_short | Improving Blood Pressure Management and Disease Severity Documentation in Patients With Acute Intracerebral Hemorrhage |
| title_sort | improving blood pressure management and disease severity documentation in patients with acute intracerebral hemorrhage |
| url | http://www.sciencedirect.com/science/article/pii/S2542454817300437 |
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