Karen E Rambo-Hernandez, Matthew C Makel, Scott J Peters, Cristina Worley
Differential return on investment: Academic growth in mathematics and reading based on initial performance
The British journal of educational psychology
surviving sepsis campaign ssc campaign developed guidelines management severe sepsis septic shock performance improvement initiative targeted changing clinical behavior process improvement via bundles based key ssc guideline recommendations process improvement patient outcomesa multifaceted intervention facilitate compliance selected guideline recommendations icu ed wards individual hospitals regional hospital networks implemented voluntarily us europe south america elements guidelines bundled two sets targets completed within 6 h within 24 h analysis conducted data submitted january 2005 march 2008data 15022 subjects 165 sites analyzed determine compliance bundle targets association hospital mortality compliance entire resuscitation bundle increased linearly 109 first site quarter 313 end 2 years p00001 compliance entire management bundle started 184 first quarter increased 361 end 2 years p 0008 compliance bundle elements increased significantly except inspiratory plateau pressure high baseline unadjusted hospital mortality decreased 37 308 2 years p 0001 adjusted odds ratio mortality improved longer site campaign resulting adjusted absolute drop 08 per quarter 54 2 years 95 ci 2584the campaign associated sustained continuous quality improvement sepsis care although necessarily cause effect reduction reported hospital mortality rates associated participation implications study may serve impetus similar improvement efforts