Evidence map›Paper›PMID 34235357›Full record

ArticlePediatric quality & safety

Multidisciplinary Kaizen Event to Improve Adherence to a Sepsis Clinical Care Guideline.

Kimberly S Denicolo, Jacqueline B Corboy, Norma-Jean E Simon, Kate J Balsley, Daniel J Skarzynski, Emily C Roben, Elizabeth R Alpern

Abstract read
In one paragraph

Article in Pediatric quality & safety. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Article
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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

7 authors.

Kimberly S DenicoloDivision of Emergency Medicine, Emergency Department, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill.
Jacqueline B CorboyDivision of Emergency Medicine, Emergency Department, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill.
Norma-Jean E SimonDivision of Emergency Medicine, Data Analytics and Reporting, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill.
Kate J BalsleyCenter for Excellence, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill.
Daniel J SkarzynskiLurie Children's Surgical Foundation, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill.
Emily C RobenDivision of Emergency Medicine, Emergency Department, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill.
Elizabeth R AlpernDivision of Emergency Medicine, Emergency Department, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSince 2015, the Ann and Robert H. Lurie Children's Hospital Emergency Department (ED) has improved the recognition and treatment of pediatric sepsis and septic shock. Despite existing clinical care guidelines, the ED had not yet achieved the Surviving Sepsis Campaign timeliness goals for fluid and antibiotic administration.

methodsThe team conducted a multidisciplinary Kaizen event to evaluate clinical workflows and identify opportunities to improve sepsis care adherence. Using rigorous quality improvement methodology, frontline providers mapped workflows to identify barriers and prioritize emerging solutions.

resultsThirty-seven staff members across 17 disciplines participated. Nurses and physicians identified communication gaps at pathway initiation. Access to supplies, inadequate task delegation, and a lack of urgency for a subset of pathway patients delayed treatment. Prioritized interventions included scripted communication tools, a delineated response plan, and standardized reassessment processes. Revisions to the key driver diagram were made after the improvement event, guiding future plan-do-study-act cycles.

conclusionsFrontline provider participation in the Kaizen event uncovered barriers to care and identified the root causes of ineffective communication and system process inefficiencies. Engaging key stakeholders from multiple care areas in a candid context was a novel approach to process improvement within our department. The Kaizen methodology is fundamental to developing sustainable quality improvement practices, creating momentum for a continuous improvement culture to engrain quality improvement in practice. The success of Kaizen will shape the format of future ED improvement projects.

Identifiers

PMID34235357
PMCPMC8225368

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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.