Prajakta Kadale, Pallavi Shidhaye, Shraddha Gurav, Pournami Ap, Manisha Ghate
Enhanced adherence counselling outcomes among people living with HIV with virological failure: Single-centre experience in Pune, India
Chronic illness
albumin continues used routinely cardiac anaesthesiologists perioperatively despite lack evidence improved outcomes multicenter perioperative outcomes group mpog data ranked institution one highest intraoperative albumin users cardiac surgery therefore designed quality improvement project qip introduce bundle interventions reduce intraoperative albumin use cardiac surgical patients institutional mpog data used analyse fluid01c measure provides number adult cardiac surgery cases albumin administered intraoperatively anaesthesiologists 1 july 2019 30 june 2022 qip involved introduction following interventions 1 education appropriate albumin use indications january 2021 2 email communications reinforced teaching march 2021 3 removal albumin standard pharmacy intraoperative medication trays april 2021 4 grand rounds presentation discussing qip highlighting interventions may 2021 5 quarterly provider feedback starting july 2021 multivariable segmented regression models used assess changes preintervention postintervention time period albumin utilisation total monthly cost among 5767 cardiac surgery cases met inclusion criteria 3year study period 16 patients received albumin intraoperatively total number cases passed metric albumin administration avoided gradually increased interventions went effect intraoperative albumin utilisation beta1011 95 ci 145 567 total monthly cost albumin beta7678 95 ci 10712 4640 demonstrated significant decrease starting interventions single academic cardiac surgery programme implementation bundle simple lowcost interventions part coordinated qip effective significantly decreasing intraoperative use albumin translated considerable costs savings