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Can didactic continuing education improve clinical decision making and reduce cost of quality? : Evidence from a case study

Vuković, Mira; Gvozdenović, Branislav S; Ranković, Milena; McCormick, Bryan P; Vuković, Danica D; Gvozdenović, Biljana D; Kastratović, Dragana A; Marković, Srdjan Z; Ilić, Miodrag and Jakovljević, Mihajlo B LU (2015) In The Journal of continuing education in the health professions 35(2). p.18-109
Abstract

INTRODUCTION: Administration of human serum albumin (HSA) solutions for the resuscitation of critically ill patients remains controversial. The objective of this study was to assess the effect of continuing medical education (CME) on health care professionals' clinical decision making with regard to HSA administration and the costs of quality (COQ). A quasi-experimental study of time series association of CME intervention with COQ and use of HSA solution was conducted at the Surgery Department of the Hospital Valjevo, Serbia. The CME contained evidence-based criteria for HSA solution administration in surgical patients. The preintervention period was defined as January 2009 to May 2011. CME was provided in June 2011, with the... (More)

INTRODUCTION: Administration of human serum albumin (HSA) solutions for the resuscitation of critically ill patients remains controversial. The objective of this study was to assess the effect of continuing medical education (CME) on health care professionals' clinical decision making with regard to HSA administration and the costs of quality (COQ). A quasi-experimental study of time series association of CME intervention with COQ and use of HSA solution was conducted at the Surgery Department of the Hospital Valjevo, Serbia. The CME contained evidence-based criteria for HSA solution administration in surgical patients. The preintervention period was defined as January 2009 to May 2011. CME was provided in June 2011, with the postintervention period June 2011 to May 2012.

METHODS: Total mortality rate, the rate of nonsurgical mortality, the rate of surgical mortality, the rate of sepsis patient mortality, index of irrational use of HSA solutions, and number of hospital days per hospitalized patient were collected for each month as quality indicators. Statistical analysis was performed by multivariate autoregressive integrated moving average (MARIMA) modeling. The specification of the COQ was performed according to a traditional COQ model.

RESULTS: The CME intervention resulted in an average monthly reduction of the hospital days per hospitalized patient, the rate of sepsis patient mortality, index of irrational use of HSA solutions, and COQ for $593,890.77 per year.

DISCUSSION: Didactic CME presenting evidence-based criteria for HSA administration was associated with improvements in clinical decisions and COQ. In addition, this study demonstrates that models combining MARIMA and traditional COQ models can be useful in the evaluation of CME interventions aimed at reducing COQ.

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author
publishing date
type
Contribution to journal
publication status
published
keywords
Clinical Decision-Making, Cost Savings, Critical Illness, Education, Medical, Continuing, Evidence-Based Medicine, Humans, Medical Staff, Hospital/education, Quality Improvement/economics, Quality of Health Care/economics, Resuscitation/methods, Serbia, Serum Albumin/administration & dosage, Surgery Department, Hospital
in
The Journal of continuing education in the health professions
volume
35
issue
2
pages
18 - 109
publisher
John Wiley and Sons Inc.
external identifiers
  • scopus:84932085829
ISSN
0894-1912
DOI
10.1002/chp.21272
language
English
LU publication?
no
id
933d748d-38ed-4f06-aa1a-602eaf89e0ef
date added to LUP
2018-09-01 22:53:07
date last changed
2018-09-16 04:56:53
@article{933d748d-38ed-4f06-aa1a-602eaf89e0ef,
  abstract     = {<p>INTRODUCTION: Administration of human serum albumin (HSA) solutions for the resuscitation of critically ill patients remains controversial. The objective of this study was to assess the effect of continuing medical education (CME) on health care professionals' clinical decision making with regard to HSA administration and the costs of quality (COQ). A quasi-experimental study of time series association of CME intervention with COQ and use of HSA solution was conducted at the Surgery Department of the Hospital Valjevo, Serbia. The CME contained evidence-based criteria for HSA solution administration in surgical patients. The preintervention period was defined as January 2009 to May 2011. CME was provided in June 2011, with the postintervention period June 2011 to May 2012.</p><p>METHODS: Total mortality rate, the rate of nonsurgical mortality, the rate of surgical mortality, the rate of sepsis patient mortality, index of irrational use of HSA solutions, and number of hospital days per hospitalized patient were collected for each month as quality indicators. Statistical analysis was performed by multivariate autoregressive integrated moving average (MARIMA) modeling. The specification of the COQ was performed according to a traditional COQ model.</p><p>RESULTS: The CME intervention resulted in an average monthly reduction of the hospital days per hospitalized patient, the rate of sepsis patient mortality, index of irrational use of HSA solutions, and COQ for $593,890.77 per year.</p><p>DISCUSSION: Didactic CME presenting evidence-based criteria for HSA administration was associated with improvements in clinical decisions and COQ. In addition, this study demonstrates that models combining MARIMA and traditional COQ models can be useful in the evaluation of CME interventions aimed at reducing COQ.</p>},
  author       = {Vuković, Mira and Gvozdenović, Branislav S and Ranković, Milena and McCormick, Bryan P and Vuković, Danica D and Gvozdenović, Biljana D and Kastratović, Dragana A and Marković, Srdjan Z and Ilić, Miodrag and Jakovljević, Mihajlo B},
  issn         = {0894-1912},
  keyword      = {Clinical Decision-Making,Cost Savings,Critical Illness,Education, Medical, Continuing,Evidence-Based Medicine,Humans,Medical Staff, Hospital/education,Quality Improvement/economics,Quality of Health Care/economics,Resuscitation/methods,Serbia,Serum Albumin/administration & dosage,Surgery Department, Hospital},
  language     = {eng},
  number       = {2},
  pages        = {18--109},
  publisher    = {John Wiley and Sons Inc.},
  series       = {The Journal of continuing education in the health professions},
  title        = {Can didactic continuing education improve clinical decision making and reduce cost of quality? : Evidence from a case study},
  url          = {http://dx.doi.org/10.1002/chp.21272},
  volume       = {35},
  year         = {2015},
}