Lack of Engagement in Surgical Quality Improvement Research Is Associated with Poorer Quality of Care

Abstract

Introduction Existing research suggests consultants who engage in national specialty-specific audits have better outcomes than those who do not. This study used public data to assess for differences between units that did or did not participate in a recent interview study. Method Risk-adjusted length of stay after elective colonic surgery was determined for all English National Health Service hospitals between January 2011 and December 2012. Units with high or low outlying length of stay were selected for interview. Public data was collected for selected units, covering a range of structures, processes and outcomes, including: number of medical staff per bed; rate of incident reporting per 100 hospital admissions; healthcare acquired infection rates; and patient and staff surveys. Participant and non-participant groups were compared using the independent samples Mann-Whitney U test. Results Fewer long length of stay units participated in interviews (10/10 units with short versus 5/12 units with long length of stay, p = 0.005). Of 56 items compared between participants and non-participants, 9 were significantly different at p 0.10. In each case, the difference suggested superior performance among participating hospitals, which had: lower rates of Clostridium difficile infections; lower rates of cancellation of elective operations; fewer staff reporting work-related stress; and higher patient survey ratings of doctors and nurses. Conclusion Failure to engage in quality improvement research may be a marker of poor performance. Future research should explore this lack of engagement, and identify strategies for overcoming barriers to participation. Organisations with poor performance may stand to benefit the most from quality improvement research. Disclosure of interest None Declared.