title: Evaluation of the impact of a quality improvement program and intensivist-directed ICU team on mortality after cardiac surgery.
abstract: OBJECTIVE
  Quality improvement is an important pursuit for critical care teams.
  
  
  METHODS
  The authors performed an observational cohort study with historic control.
  
  
  METHODS
  Eight-bed cardiac surgery ICU in a tertiary university hospital.
  
  
  METHODS
  A total of 4,866 patients undergoing cardiac surgery over a 6-year period between January 2005 and December 2010.
  
  
  METHODS
  In this study, the influence of the introduction of a quality improvement program under the supervision of a newly appointed intensivist on patient outcomes after cardiac surgery was evaluated. Patients were further divided into three 2-year periods: Period I, 2005-2006, before appointment of an intensivist; Period II, 2007-2008, after appointment of an intensivist and initial introduction of a quality improvement program; and Period III, 2009-2010, after implementation of the program and introduction of Critical Care Information Systems.
  
  
  RESULTS
  There were 1,633, 1,690, and 1,543 patients in each period, respectively. There was no significant difference in the severity of patient illness between the groups. Unadjusted in-hospital mortality decreased from 6.37% (104 patients) in Period I to 4.32% (73 patients) and 3.3% (51 patients) in Periods II and III, respectively (p< 0.01).
  
  
  CONCLUSIONS
  Appointment of an intensivist-directed team model and introduction of quality improvement interventions were associated with decreased mortality after cardiac surgery.
authors.affiliation: Departments of *Cardiac Surgery and. Electronic address: alexander.kogan@sheba.health.gov.il.
authors.forename: Alexander
authors.initials: A
authors.lastname: Kogan
authors.forename: Sergey
authors.initials: S
authors.lastname: Preisman
authors.forename: Haim
authors.initials: H
authors.lastname: Berkenstadt
authors.forename: Eran
authors.initials: E
authors.lastname: Segal
authors.forename: Yigal
authors.initials: Y
authors.lastname: Kassif
authors.forename: Leonid
authors.initials: L
authors.lastname: Sternik
authors.forename: Boris
authors.initials: B
authors.lastname: Orlov
authors.forename: Edna
authors.initials: E
authors.lastname: Shalom
authors.forename: Shany
authors.initials: S
authors.lastname: Levin
authors.forename: Ateret
authors.initials: A
authors.lastname: Malachy
authors.forename: Jacob
authors.initials: J
authors.lastname: Lavee
authors.forename: Ehud
authors.initials: E
authors.lastname: Raanani
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000379:methods* / Q000401:mortality*; D002648:Child; D015331:Cohort Studies; D003422:Critical Care / Q000379:methods*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007857:Leadership; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010348:Patient Care Team / Q000458:organization & administration*; D010820:Physicians; D058996:Quality Improvement; D012372:ROC Curve; D018570:Risk Assessment; D013318:Stroke Volume / Q000502:physiology; D016896:Treatment Outcome; D055815:Young Adult
keywords: cardiac surgery; postoperative care; quality improvement