ReviewBMJ open quality2025
Quality improvement methodology used in enhanced recovery after caesarean delivery implementation studies: a narrative review and author survey.
Review in BMJ open quality, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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.
The trial behind it
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Who cites it
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Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEnhanced recovery after caesarean delivery (ERAC) is gaining popularity and has been shown to improve maternal and neonatal outcomes. We aimed to identify the presence and type of quality improvement (QI) methodology used in ERAC studies through an exploratory analysis, including author surveys and literature review.
methodsWe performed a literature search using four databases (MEDLINE through PubMed, Cumulative Index of Nursing and Allied Health Literature, Web of Science and Embase) to identify ERAC studies. Studies were considered if they compared an 'enhanced' or 'fast track' protocol to a control group and evaluated more than one system or outcome. The adopted QI methodology was evaluated through a standardised questionnaire developed by the authors which was sent to the authors of included studies.
resultsWe identified 29 studies. A standardised questionnaire was applied to all included papers to evaluate the presence and type of QI methodology, and 24 authors were approached to complete the survey. We received results from 15 authors, yielding a response rate of 63%. 40% of authors reported use of defined QI methodology, the majority using the Model for Improvement. The QI components most used by those not reporting use of a defined methodology were engagement with multidisciplinary key stakeholders (80%), use of key drivers (87%) and process mapping (60%). Most authors reported use of traditional statistical methodology when analysing results (73%), and 60% reported use of Standards for Quality Improvement Reporting Excellence guidelines. The mean duration of baseline data collection by non-randomised controlled trial studies was 11 months and 9.9 months after implementation.
conclusionThere is a large variation in the QI practices used in protocol implementation and publication of ERAC studies. The minority of authors report the use of a defined QI methodology and very few report the use of standardised tools in their published works. PROSPERO REGISTRATION NUMBER: CRD42023399418.
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Registered trials
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.