Simple signage and targeted education can lead to process improvement in acute appendicitis care

IntroductionAn institution-wide protocol for uncomplicated acute appendicitis was created to improve compliance with best practices between the emergency department (ED), radiology and surgery. Awareness of the protocol was spread with the publication of a smartphone application and communication to...

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Bibliographic Details
Published in:BMJ open quality 2023-10, Vol.12 (4), p.e002327
Main Authors: Atwood, Rex, Benoit, Patrick, Hennrikus, William, Kraemer, Laura, Gunasingha, Rathnayaka Mudiyanselage, Kindvall, Angela, Jessie, Elliot, Gosztyla, Carolyn, Bradley, Matthew
Format: Article
Language:English
Subjects:
Antibiotics
Antimicrobial agents
Appendectomy
Appendicitis
Clinical medicine
Compliance
Disease prevention
Education
Emergency medical care
Health professions education
Healthcare quality improvement
Initiatives
Intervention
Laparoscopy
Medical records
Medicine
Original Research
Patients
Signs
Smartphones
Surgery
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Summary:IntroductionAn institution-wide protocol for uncomplicated acute appendicitis was created to improve compliance with best practices between the emergency department (ED), radiology and surgery. Awareness of the protocol was spread with the publication of a smartphone application and communication to clinical leadership. On interim review of quality metrics, poor protocol adherence in diagnostic imaging and antimicrobial stewardship was observed. The authors hypothesised that two further simple interventions would result in more efficient radiographic diagnosis and antimicrobial administration.Materials and methodsSurgery residents received targeted in-person education on the appropriate antibiotic choices and diagnostic imaging in the protocol. Signs were placed in the emergency and radiology work areas, immediately adjacent to provider workstations highlighting the preferred imaging for patients with suspected appendicitis and the preferred antibiotic choices for those with proven appendicitis. Protocol adherence was compared before and after each intervention.ResultsTargeted education was associated with improved antibiotic stewardship within the surgical department from 30% to 91% protocol adherence before/after intervention (p
ISSN:2399-6641
2399-6641
DOI:10.1136/bmjoq-2023-002327