Process measure improvement per hospital temporally associated with participation in the EPOCH trial QI programme
| Care processes | Data signals (shifts and runs) identified on run chart analysis | |||
| Number (%) of hospitals with care process improvement observed n=80 | Number (%) of hospitals with median baseline care process delivery ≥80% n=80 | Number (%) of hospitals with degraded care-process after activation to EPOCH n=80 | % Difference post intervention vs pre intervention (median, IQR, range) | |
| 1. Consultant led decision making | 14 (17.5) | 71 (88.8) | 6 (7.5) | 0.44 (2.53–3.35, −16.19 to 20.33) |
| 2. Consultant review of patient before surgery | 17 (21.25) | 14 (17.5) | 4 (5) | 2.4109 (−3.67 to 6.37, −18.19 to 17.73) |
| 3. Preoperative risk assessment documented | 57 (71.25) | 6 (7.5) | 3 (3.8) | 13.66 (3.25–23.48, −21.75 to 52.15) |
| 4. Time from decision to operate to entrance to the operating theatre | 14 (17.5) | 2 (2.5) | 5 (6.3) |
Time in hours
−0.500 (−1.30 to 0.37, −8.25 to 3.4083) |
| 5. Time to theatre within NCEPOD timeframe | 22 (27.5) | 32 (40) | 2 (2.5) | 8.391 (1.65–12.18, −7.81 to 25.65) |
| 6. Consultant delivered surgery | 24 (30.0) | 70 (87.5) | 2 (2.5) | 1.913 (−1.96 to 6.52, −13.86 to 18.66) |
| 7. Consultant delivered anaesthesia | 29 (36.25) | 57 (71.3) | 4 (5) | 3.8416 (−0.74 to 8.68, −22.948 to 30.30) |
| 8. Cardiac output monitoring to guide fluid therapy | 32 (40.0) | 3 (3.8) | 11 (13.8) | 4.766 (−1.10 to 13.25, −29.21 to 50.72) |
| 9. Measurement of serum lactate intraoperatively | 42 (52.5) | 3 (3.8) | 3 (3.8) | 9.270 (2.14–17.52, −28.09 to 39.86) |
| 10. Admission to critical care postoperatively | 28 (35.0) | 15 (18.8) | 3 (3.8) | 2.222 (−3.62 to 7.33, −17.69 to 26.88) |
EPOCH, Enhanced Peri-Operative Care for High-risk patients .