Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Reducing kidney injury using a quality improvement method

30.07.2014

Using quality improvement measures in eight of the 10 hospitals in the Northern New England Cardiovascular Disease Study Group, researchers have found a way to reduce kidney injury in patients undergoing a procedure with contrast dye.

Currently, 7-15 percent of these patients who undergo a coronary stent procedure with contrast-dye end up with kidney injury, which can result in death or rapid decline in kidney function leading to temporary or permanent dialysis, says a study published in the July issue of Circulation Cardiovascular Quality Outcomes journal.

Previous to this study, based on quality improvement methods in the hospitals, little has been done to adopt evidence-based interventions though it has been a patient safety objective of the National Quality Forum.

While researchers looked specifically at patients in the cardiology catheterization lab, they believe the methods they developed over a six-year period to prevent kidney injury are generalizable to all of medicine and contrast procedures.

... more about:
»Cardiovascular »Health »Medicine »Quality »injury

"We believe that using a team-based approach and having teams at different medical centers in northern New England learn from one-another to provide the best care possible for their patients," said Jeremiah Brown of The Dartmouth Institute for Health Policy & Clinical Practice.

Brown and his colleagues found that using a quality improvement design and team coaching, they could reduce kidney injury by 20 percent among all patients and by 30 percent among patients with pre-existing chronic kidney disease.

"Some of the most innovative ideas came from these teams and identified simple solutions to protect patients from kidney injury resulting from the contrast dye exposure," Brown said. "These included getting patients to self-hydrate with water before the procedure (8 glasses of water before and after the procedure), allow patients to drink fluids up to two hours before the procedure (whereas before they were "NPO" for up to 12 hours and came to the hospital dehydrated), training the doctors to use less contrast in the procedure (which is good for the patient and saves the hospital money), and creating stops in the system to delay a procedure if that patient had not received enough oral or intravenous fluids before the case (rather, they would delay the case until the patient received adequate fluids)."

Using a simple team-based approach, Brown and colleagues from 10 medical centers in northern New England prevented kidney injury in 1 out of every 5 patients undergoing a cardiac catheterization procedure.

"Our regional success was really about hospital teams talking and innovating with one another. Instead of competing with one another in similar health care markets, they shared their data, protocols, and ideas resulting in simple, homegrown, easy to do solutions that improved patient safety across the region," Brown said.

###

To view the abstract of the article in the journal Circulation Cardiovascular Quality Outcomes please go to http://circoutcomes.ahajournals.org/content/early/2014/07/29/CIRCOUTCOMES.114.000903.

Jeremiah R. Brown, PhD, MS, is an Assistant Professor of The Dartmouth Institute for Health Policy & Clinical Practice and Departments of Medicine and Community and Family Medicine, Geisel School of Medicine at Dartmouth.

The Dartmouth Institute for Health Policy & Clinical Practice was founded in 1988 by Dr. John E. Wennberg as the Center for the Evaluative Clinical Sciences (CECS). Among its 25 years of accomplishments, it has established a new discipline and educational focus in the Evaluative Clinical Sciences, introduced and advanced the concept of shared decision-making for patients, demonstrated unwarranted variation in the practice and outcomes of medical treatment, developed the first comprehensive examination of US health care variations (The Dartmouth Atlas), and has shown that more health care is not necessarily better care.

Derik Hertel | Eurek Alert!
Further information:
http://www.dartmouth.edu

Further reports about: Cardiovascular Health Medicine Quality injury

More articles from Health and Medicine:

nachricht Mass. General team generates therapeutic nitric oxide from air with an electric spark
07.07.2015 | Massachusetts General Hospital

nachricht UNC researchers find 2 biomarkers linked to severe heart disease
07.07.2015 | University of North Carolina Health Care

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Surfing a wake of light

Researchers observe and control light wakes for the first time

When a duck paddles across a pond or a supersonic plane flies through the sky, it leaves a wake in its path. Wakes occur whenever something is traveling...

Im Focus: Light-induced Magnetic Waves in Materials Engineered at the Atomic Scale

Researchers explore ultrafast control of magnetism across interfaces: A new study discovers how the sudden excitation of lattice vibrations in a crystal can trigger a change of the magnetic properties of an atomically-thin layer that lies on its surface.

A research team, led by scientists of the Max Planck Institute for the Structure and Dynamics of Matter at CFEL in Hamburg, the University of Oxford, and the...

Im Focus: Viaducts with wind turbines, the new renewable energy source

Wind turbines could be installed under some of the biggest bridges on the road network to produce electricity. So it is confirmed by calculations carried out by a European researchers team, that have taken a viaduct in the Canary Islands as a reference. This concept could be applied in heavily built-up territories or natural areas with new constructions limitations.

The Juncal Viaduct, in Gran Canaria, has served as a reference for Spanish and British researchers to verify that the wind blowing between the pillars on this...

Im Focus: X-rays and electrons join forces to map catalytic reactions in real-time

New technique combines electron microscopy and synchrotron X-rays to track chemical reactions under real operating conditions

A new technique pioneered at the U.S. Department of Energy's Brookhaven National Laboratory reveals atomic-scale changes during catalytic reactions in real...

Im Focus: Iron: A biological element?

Think of an object made of iron: An I-beam, a car frame, a nail. Now imagine that half of the iron in that object owes its existence to bacteria living two and a half billion years ago.

Think of an object made of iron: An I-beam, a car frame, a nail. Now imagine that half of the iron in that object owes its existence to bacteria living two and...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

World Conference on Regenerative Medicine in Leipzig: Last chance to submit abstracts until 2 July

25.06.2015 | Event News

World Conference on Regenerative Medicine: Abstract Submission has been extended to 24 June

16.06.2015 | Event News

MUSE hosting Europe’s largest science communication conference

11.06.2015 | Event News

 
Latest News

Down to the quantum dot

07.07.2015 | Physics and Astronomy

Tundra study uncovers impact of climate warming in the Arctic

07.07.2015 | Earth Sciences

Transition from 3 to 2 dimensions increases conduction, MIPT scientists discover

07.07.2015 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>