Evidence map›Paper›PMID 30297375›Full record

ArticleBMJ quality & safety2019

Effectiveness of a multistate quality improvement campaign in reducing risk of surgical site infections following hip and knee arthroplasty.

Michael S Calderwood, Deborah S Yokoe, Michael V Murphy, Katherine O DeBartolo, Kathy Duncan, Christina Chan, Eric C Schneider, Gareth Parry, Don Goldmann, Susan Huang

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ quality & safety, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Michael S CalderwoodSection of Infectious Disease and International Health, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA Michael.S.Calderwood@Hitchcock.org.
Deborah S YokoeDivision of Infectious Diseases, University of California San Francisco, San Francisco, California, USA.
Michael V MurphyDepartment of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.
Katherine O DeBartoloInstitute for Healthcare Improvement, Boston, Massachusetts, USA.
Kathy DuncanInstitute for Healthcare Improvement, Boston, Massachusetts, USA.
Christina ChanDepartment of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.
Eric C SchneiderThe Commonwealth Fund, New York City, New York, USA.
Gareth ParryInstitute for Healthcare Improvement, Boston, Massachusetts, USA.
Don GoldmannInstitute for Healthcare Improvement, Boston, Massachusetts, USA.
Susan HuangDivision of Infectious Diseases and Healthy Policy Research Institute, University of California Irvine School of Medicine, Irvine, California, USA.

Funding

AHRQ HHS R18 HS021424
6 · The paper itself

Abstract

backgroundQuality improvement (QI) campaigns appear to increase use of evidence-based practices, but their effect on health outcomes is less well studied.

objectiveTo assess the effect of a multistate QI campaign (Project JOINTS, Joining Organizations IN Tackling SSIs) that used the Institute for Healthcare Improvement's Rapid Spread Network to promote adoption of evidence-based surgical site infection (SSI) prevention practices.

methodsWe analysed rates of SSI among Medicare beneficiaries undergoing hip and knee arthroplasty during preintervention (May 2010 to April 2011) and postintervention (November 2011 to September 2013) periods in five states included in a multistate trial of the Project JOINTS campaign and five matched comparison states. We used generalised linear mixed effects models and a difference-in-differences approach to estimate changes in SSI outcomes.

results125 070 patients underwent hip arthroplasty in 405 hospitals in intervention states, compared with 131 787 in 525 hospitals in comparison states. 170 663 patients underwent knee arthroplasty in 397 hospitals in intervention states, compared with 196 064 in 518 hospitals in comparison states. After the campaign, patients in intervention states had a 15% lower odds of developing hip arthroplasty SSIs (OR=0.85, 95% CI 0.75 to 0.96, p=0.01) and a 12% lower odds of knee arthroplasty SSIs than patients in comparison states (OR=0.88, 95% CI 0.78 to 0.99, p=0.04).

conclusionsA larger reduction of SSI rates following hip and knee arthroplasty was shown in intervention states than in matched control states.

Indexed as

Quality ImprovementAgedAged, 80 and overArthroplasty, Replacement, HipArthroplasty, Replacement, KneeEvidence-Based PracticeFemaleHealth Care SurveysHumansInsurance Claim ReviewMaleMedicareMiddle AgedProgram EvaluationSurgical Wound InfectionUnited Statesevidence-based medicinenosocomial infectionsquality improvementsurgery

Identifiers

PMID30297375
PMCPMC9290409

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.