Department of Pediatrics, Division of Pulmonary Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, , Chicago, Illinois, USA.
BMJ Qual Saf. 2014 Apr;23 Suppl 1:i81-9. doi: 10.1136/bmjqs-2013-002314.
To describe the characteristics of sustained improved nutritional outcomes through the use of quality improvement (QI) methodology.
Retrospective analysis of a QI intervention in two institutions, implemented as part of larger national collaboratives.
Paediatric cystic fibrosis (CF) programmes in academic centres in Alabama and Illinois.
All paediatric patients enrolled in the CF Foundation (CFF) Patient Data Registry were included.
Improved and sustained nutrition outcomes occurred through implementation of the CFF practice guidelines for CF nutrition management via care delivery processes, nutritional interventions, team engagement and data display.
Mean body mass index (BMI) percentile, percentage of patients less than 50th percentile and percentage less than 10th percentile for all patients aged 2-20 years were tracked through run charts and statistical process control charts. Mann-Whitney U and χ(2) tests were used to determine significance between each centre and national outcomes.
Each centre achieved rapid improvement in mean BMI percentile in patients, one centre rising from the 40th percentile in 2001 to the 49th percentile in 2003, the other rising from the 37th percentile in 2003 to the 45th percentile in 2004. These centres have also maintained improved nutritional outcomes, so that they were at the 60th and 55th percentiles, respectively, in 2011. Sustained improvement was accomplished through QI methodology, use of data as a driver for improvement and a change in culture.
Participation in collaboratives led to improved nutrition outcomes while a strong culture of QI facilitated sustained improvement.
描述通过使用质量改进（QI）方法实现持续改善营养结果的特点。
对在两个机构中实施的 QI 干预的回顾性分析，该干预是更大的国家合作的一部分。
阿拉巴马州和伊利诺伊州学术中心的儿科囊性纤维化（CF）计划。
所有登记在 CF 基金会（CFF）患者数据登记处的儿科患者均包括在内。
通过实施 CFF 囊性纤维化营养管理实践指南，通过护理提供流程、营养干预、团队参与和数据显示来改善和维持营养结果。
通过运行图和统计过程控制图跟踪所有 2-20 岁患者的平均体重指数（BMI）百分位数、低于 50 百分位的患者百分比和低于 10 百分位的患者百分比。使用 Mann-Whitney U 和 χ(2)检验来确定每个中心与全国结果之间的显著性差异。
每个中心的患者平均 BMI 百分位数都迅速提高，一个中心从 2001 年的第 40 百分位上升到 2003 年的第 49 百分位，另一个中心从 2003 年的第 37 百分位上升到 2004 年的第 45 百分位。这些中心也保持了改善的营养结果，因此，他们分别在 2011 年达到了第 60 百分位和第 55 百分位。通过 QI 方法、使用数据作为改进驱动力以及文化的改变，实现了持续的改进。
参与合作导致营养结果改善，而强大的 QI 文化促进了持续的改进。
