Evidence map›Paper›PMID 31986120›Full record

ArticleBMJ open quality2020

Quality improvement of intravenous to oral medication conversion using Lean Six Sigma methodologies.

Julie Downen, Cassie Jaeger

Open access · goldAbstract read
In one paragraph

Article in BMJ open quality, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.1field-weighted citation impact, top 26% of its field
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

6 citing papers in PubMed, 11 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. A Health Technology Assessment in Maxillofacial Cancer Surgery by Using the Six Sigma Methodology.International journal of environmental research and public health · 2021
    Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors at 1 institution in 1 country.

Julie DownenPharmacy, Memorial Medical Center, Springfield, Illinois, USA.
Cassie JaegerOperations Improvement, Memorial Medical Center, Springfield, Illinois, USA Hawk.Cassie@mhsil.com.ORCID 0000-0002-2726-6867
Memorial Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionLack of medication conversion from intravenous to oral contributes to increased risk of infection, delayed discharges and higher medication costs. At our institution, intravenous to oral medication conversion rate was 76% with missed opportunity for conversion of 37%. The goal of the project was to reduce the percent of missed opportunities for intravenous to oral conversion for applicable medications.

methodsA pharmacy-driven intravenous to oral policy and procedure was implemented. To identify potential opportunities, a patient worklist of applicable intravenous to oral medications was created for pharmacy review in real time. An intravenous to oral conversion order was implemented in the computerised provider order entry. 'Convert to oral' was added as an option in the electronic medication request and highlighted reminders were added to the electronic medication administration record for eligible medications.

resultsAfter improvements, the missed opportunity rate for intravenous to oral conversion decreased from 37% (19/51) to 21% (24/113) (p=0.04, two-proportion test), a 43% improvement. The trend in intravenous to oral conversion rate increased from 76% (39/51) to 85% (171/201) and severity adjusted length of stay was reduced from 8.1 days to 6.4 days post improvements (p<0.001, t-test).

Indexed as

Administration, IntravenousAdministration, OralMedical Order Entry SystemsPharmaceutical ServicesQuality ImprovementTotal Quality ManagementHumansPharmaceutical PreparationsPharmaceutical Preparationsantibiotic managementelectronic prescribinghealthcare quality improvementpatient dischargeSix Sigma

Identifiers

PMID31986120
PMCPMC7011893
OpenAlexW3002046644

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.