Department of Health Sciences, Brock University, St. Catharines, ON, Canada.
BC Patient Safety & Quality Council, Vancouver, BC, Canada.
Crit Care Med. 2022 Apr 1;50(4):e340-e350. doi: 10.1097/CCM.0000000000005353.
Sepsis is a life-threatening medical emergency. There is a paucity of information on whether quality improvement approaches reduce the in-hospital sepsis caseload or save lives and decrease the healthcare system and society's cost at the provincial/national levels. This study aimed to assess the outcomes and economic impact of a province-wide quality improvement initiative in Canada.
Retrospective population-based study with interrupted time series and return on investment analyses.
The sepsis cases and deaths averted over time for British Columbia were calculated and compared with the rest of Canada (excluding Quebec and three territories).
Aggregate data were obtained from the Canadian Institute for Health Information on risk-adjusted in-hospital sepsis rates and sepsis mortality in acute care sites across Canada.
In 2012, the British Columbia Sepsis Network was formed to reduce sepsis occurrence and mortality through education, knowledge translation, and quality improvement.
A return on investment analysis compared the financial investment for the British Columbia Sepsis Network with the savings from averted sepsis occurrence and mortality. An estimated 981 sepsis cases and 172 deaths were averted in the post-British Columbia Sepsis Network period (2014-2018). The total cost, including the development and implementation of British Columbia Sepsis Network, was $449,962. Net savings due to cases averted after program costs were considered were $50.6 million in 2018. This translates into a return of $112.5 for every dollar invested.
British Columbia Sepsis Network appears to have averted a greater number of sepsis cases and deaths in British Columbia than the national average and yielded a positive return on investment. Our findings strengthen the policy argument for targeted quality improvement initiatives for sepsis care and provide a model of care for other provinces in Canada and elsewhere globally.
脓毒症是一种危及生命的医疗紧急情况。关于质量改进方法是否可以减少医院内脓毒症的发生，或者是否可以拯救生命，以及是否可以降低省级/国家级别的医疗保健系统和社会成本，相关信息非常有限。本研究旨在评估加拿大全省范围内质量改进举措的结果和经济影响。
回顾性基于人群的研究，采用中断时间序列和投资回报分析。
不列颠哥伦比亚省的脓毒症病例和避免的死亡人数随时间计算，并与加拿大其他地区（魁北克省和三个地区除外）进行比较。
从加拿大卫生信息研究所获得了加拿大各地急性护理机构的风险调整院内脓毒症发生率和脓毒症死亡率的综合数据。
2012 年，不列颠哥伦比亚省脓毒症网络成立，通过教育、知识转化和质量改进来降低脓毒症的发生和死亡率。
投资回报分析比较了不列颠哥伦比亚省脓毒症网络的财务投资与避免发生脓毒症和死亡率节约的费用。在不列颠哥伦比亚省脓毒症网络之后的时期（2014-2018 年），估计避免了 981 例脓毒症病例和 172 例死亡。包括不列颠哥伦比亚省脓毒症网络的开发和实施在内的总成本为 449962 加元。考虑到项目成本后，因避免病例而节省的费用为 2018 年的 5060 万加元。这意味着每投资 1 加元，回报率为 112.5 加元。
不列颠哥伦比亚省脓毒症网络似乎在不列颠哥伦比亚省避免了比全国平均水平更多的脓毒症病例和死亡，并产生了积极的投资回报。我们的研究结果为脓毒症护理的有针对性的质量改进举措提供了政策论据，并为加拿大其他省份和全球其他地区提供了一种护理模式。
