locating epic/phsi in a sea of acronyms (cnn; cihr-phsi; epic; epic/phsi) shoo k. lee, mbbs, frcpc,...
Post on 01-Jan-2016
219 Views
Preview:
TRANSCRIPT
Locating EPIC/PHSI in a Sea of Acronyms
(CNN; CIHR-PHSI; EPIC; EPIC/PHSI)
Shoo K. Lee, MBBS, FRCPC, PhDDirector, Canadian Neonatal Network™
Scientific Director, iCAREProfessor of Pediatrics, University of Alberta
EPIC/PHSI Training WorkshopNovember 9 & 10, 2006
Toronto Ontario
ObjectivesObjectives
• Overview CNNTM
• Overview CIHR
• Overview EPIC/PHSI
• Locate EPIC/PHSI in CNN and CIHR
Canadian Neonatal Network™
(CNN)
Background of CNNBackground of CNN Founded in 1995 Multidisciplinary researchers 30 hospitals & 16 universities across Canada
All 30 tertiary NICUs in Canada
Standardized NICU database CNN researchers have published extensively in
peer-reviewed journals and made many presentations at scientific conferences
Objective of CNNObjective of CNN
To conduct leading, innovative, To conduct leading, innovative, collaborative research leading to collaborative research leading to improvements in neonatal-perinatal health improvements in neonatal-perinatal health and the quality of healthcare in Canada and the quality of healthcare in Canada and internationally.and internationally.
Structure of CNNStructure of CNN
Canadian Neonatal Network™Canadian Neonatal Network™
Network Coordinating CentreEdmonton
Network Coordinating CentreEdmonton Participating InstitutionsParticipating Institutions Steering CommitteeSteering Committee
Project CoordinatorAireen Wingert
Database ManagerJack Yeung
Data AnalystKate Zhang
Knowledge BrokerDavid S Thompson
Project CoordinatorAireen Wingert
Database ManagerJack Yeung
Data AnalystKate Zhang
Knowledge BrokerDavid S Thompson
Site Investigator
Individual Membership
Data Abstractor
Site Investigator
Individual Membership
Data Abstractor
6 elected members
set Network/database policies ensure Network goals are met
6 elected members
set Network/database policies ensure Network goals are met
Kingston
CNN SitesCNN Sites
Vancouver
New Westminster
Victoria
EPIC/PHSI Sites--25
CalgaryRegina
Saskatchewan
Winnipeg
LondonHamilton
Ottawa
Toronto
SherbrookeMontréal
Québec City Moncton
St. John’s
Fredericton
HalifaxSt. John
Kingston
CNN Sites--30
Canadian Institute of Health Research
(CIHR)
CIHRCIHR
CIHR Mandate"To excel, according to internationally accepted standards of scientific excellence, in the creation of new knowledge and its translation into improved health for Canadians, more effective health services and products and a strengthened Canadian health care system."
CIHR - Partnerships for Health System CIHR - Partnerships for Health System Improvement (PHSI)Improvement (PHSI)
• The purpose of this initiative is to support teams of researchers and decision-makers interested in conducting applied health research useful to health system managers and/or policy makers over the next two-to-five years.
• EPIC/PHSI funded for $100,000 x 3 years
CIHR and Knowledge TranslationCIHR and Knowledge Translation
• Knowledge translation is the exchange, synthesis and ethically-sound application of knowledge - within a complex system of interactions among researchers and users - to accelerate the capture of the benefits of research for Canadians through improved health, more effective services and products, and a strengthened health care system
• EPIC/PHSI is built upon knowledge translation
Evidence-based PracticeEvidence-based PracticeIdentification and ChangeIdentification and Change
(EPIC)(EPIC)
EPIC/PHSIEPIC/PHSI
Evidence-based Practice Evidence-based Practice Identification and Change (EPIC)Identification and Change (EPIC)
Scientific method for quality improvement
Innovation - 3 pillars:
1. Evidence-based Uses published research literature
2. Variations in outcomes for targeted intervention Use data to identify practices associated with variations in outcomes
3. Combined expertise Uses a national network of clinicians and experts to share expertise and
experience
A template that is generalizable to all NICUs
Create culture of continuous quality improvement and evidence-based practice and change
EPIC-I Results: Group A (NIT)EPIC-I Results: Group A (NIT)
NIT(intervention group)
24.1%
17.1%
21.5%
12.5%
15.6% 16.4% 15.8% 15.5%13.1%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
baseline Oct03-Dec03
Jan04-Mar04
Apr04-Jun04
Jul04-Sept04
Oct04-Dec04
Jan05-Mar05
Apr05-Jun05
Jul05-Sept05
Quarter
Percen
tag
e o
f N
I (ever in
fected
)NIT (control group)
32.7%
28.3%
38.0%
28.2% 28.3%
33.0%29.5% 29.5%
32.2%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
40.0%
45.0%
50.0%
baseline Oct03-Dec03
Jan04-Mar04
Apr04-Jun04
Jul04-Sept04
Oct04-Dec04
Jan05-Mar05
Apr05-Jun05
Jul05-Sept05
Quarter
Pe
rce
nta
ge
of
CL
D
EPIC-I Results: Group B (CLD)EPIC-I Results: Group B (CLD)CLD (intervention gruop)
31.5%28.9% 30.0%
28.2% 28.5% 27.8%25.3%
27.4%
21.7%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
40.0%
baseline Oct03-Dec03
Jan04-Mar04
Apr04-Jun04
Jul04-Sept04
Oct04-Dec04
Jan05-Mar05
Apr05-Jun05
Jul05-Sept05
Quarter
Pe
rce
nta
ge
o
f C
LD
CLD (control grup)
17.8%
13.7%15.0%
10.0%
12.4% 12.8%
10.1%8.0% 7.1%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
baseline Oct03-Dec03
Jan04-Mar04
Apr04-Jun04
Jul04-Sept04
Oct04-Dec04
Jan05-Mar05
Apr05-Jun05
Jul05-Sept05
Quarter
Percentage of N
I (ever in
fected)
EPIC-I Results: Group C (Controls)EPIC-I Results: Group C (Controls)control group (Non-EPIC group)
37.85%
31.54% 30.61%
38.98% 40.60%
29.17%31.94%
36.56%35.71%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
baseline Oct-Dec03
Jan-Mar04
Apr-Jun04
Jul-Sept04
Oct-Dec04
Jan-Mar05
Apr-Jun05
Jul-Sept05
Quarter
Percentage of B
PD
babie
s
control group (Non-EPIC group)
12.3%
6.0%
14.5%16.0%
13.7%
7.2%
11.8%10.3%
14.0%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
baseline Oct03-Dec03
Jan04-Mar04
Apr04-Jun04
Jul04-Sept04
Oct04-Dec04
Jan05-Mar05
Apr05-Jun05
Jul05-Sept05
Quarter
Perc
enta
ge o
f N
I(ever
infe
cte
d)
EPIC-I ConclusionsEPIC-I Conclusions
• EPIC is effective at reducing NI and BPD in the NICU
• Interventions targeting one outcome may affect other outcomes
• EPIC may be more effective and less costly at improving quality of care than traditional CQI methods
EPIC/PHSI ObjectivesEPIC/PHSI Objectives
• Test the generalizeability of EPIC
• Determine the sustainability of EPIC
• Establish and evaluate a national system to support NICU quality improvement efforts based on EPIC
top related