title: Impact of modified quality control checklist on protocol adherence and outcomes in a post-surgical Intensive Care Unit.
abstract: OBJECTIVE
  Quality improvement (QI) is the sum of all activities that create desired changes in the quality. An effective QI system results in a stepwise increase in quality of care. The efficiency of any health-care unit is judged by its quality indicators. We aimed to evaluate the impact of QI initiatives on outcomes in a surgical Intensive Care Unit (ICU).
  
  
  METHODS
  This was an observational study carried out using a compliance checklist, developed from the combination of the World Health Organization surgery checklist and Society for Healthcare Epidemiology of America guidelines for the prevention of infections. A total of 170 patients were prospectively evaluated for adherence to the checklist and occurrence of infections. This was compared with a random retrospective analysis of 170 patients who had undergone similar surgeries in the previous 3 months.
  
  
  RESULTS
  Introduction and supervised documentation of comprehensive checklist brought out significant improvement in the documentation of quality indicators (98% vs. 32%) in the prospective samples. There was no difference in mortality, health-care-related infection rates or length of ICU stay.
  
  
  CONCLUSIONS
  The introduction of comprehensive surgical checklist improved documentation of parameters for quality control but did not decrease the rates of infection in comparison to the control sample.
authors.affiliation: Department of Anaesthesiology and Critical Care, Amrita Institute of Medical Sciences (Amrita Vishwa Vidyapeetham), Kochi, Kerala, India.
authors.forename: Lakshmi
authors.initials: L
authors.lastname: Kumar
authors.affiliation: Hospital Administration, Amrita Institute of Medical Sciences (Amrita Vishwa Vidyapeetham), Kochi, Kerala, India.
authors.forename: Meenu
authors.initials: M
authors.lastname: Dominic
authors.affiliation: Department of Anaesthesiology and Critical Care, Amrita Institute of Medical Sciences (Amrita Vishwa Vidyapeetham), Kochi, Kerala, India.
authors.forename: Sunil
authors.initials: S
authors.lastname: Rajan
authors.affiliation: Hospital Administration, Amrita Institute of Medical Sciences (Amrita Vishwa Vidyapeetham), Kochi, Kerala, India.
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Singh
keywords: Line care-bundles; quality control; surgery; surgical site infection