Improving first-pass success rates during emergency intubation at an academic emergency department: a quality improvement initiative

• Published in: International journal for quality in health care 2021-09, Vol.33 (3)
• Main Authors: Bakhsh, Abdullah, Alharbi, Ahd, Almehmadi, Raghad, Kamfar, Sara, Aldhahri, Arwa, Aledeny, Ahmed, Ashour, Yasmeen, Khojah, Imad
• Format: Article
• Language: English
• ISSN: 1353-4505; 1464-3677
• DOI: 10.1093/intqhc/mzab132

Abstract Background Airway management is a high-stakes procedure in emergency medicine. Continuously monitoring this procedure allows performance improvement while revealing safety issues. We instituted a quality improvement initiative in the emergency department to improve first-pass success rates in the emergency department. Methods This was a quality improvement initiative at an academic emergency department from 2018 to 2020. We developed a rapid sequence intubation guideline for procedure standardization and introduced an intubation procedure note for performance monitoring. Data were entered directly by the primary physician and nurse during intubation. The quality improvement team thereafter collected the data retrospectively and entered into a local airway database. More importantly, we introduced a culture of quality improvement and safety in airway management via regular education and feedback. Results We included a total of 146 intubations. The first-pass success rate started at 57.1% and increased to 80.0% during the study period (P