Implementing change in perfusion practice: quality improvement vs. experimentation?

Abstract

The desire to optimize techniques and interventions that comprise clinical practice will inevitably involve the implementation of change in the process of care. To confirm the intended benefits of instituting clinical change, the process should be undertaken in a scientific manner. Although implementing changes in perfusion practice is limited by the availability of evidence based practice guidelines, we have the opportunity to audit our current practice according to institutional guidelines using quality improvement methods. Current electronic data collection technology is a useful tool available to facilitate the reporting of both clinical and process outcome improvements. The model of clinical effectiveness can be used as a systematic approach to introducing change in clinical practice, which involves reviewing the literature, acquiring appropriate skills and resources, auditing the change, and implementing continuous quality improvement to standardize the process. Finally, reporting the findings allows dissemination of the knowledge that can be generalized. Reporting change strengthens our efforts in clinical effectiveness, highlights the importance of perfusion practice, and increases the influence of the profession.

Figure 1.

A model for clinical effectiveness that can be used as a struc-ture for instituting change in clinical practice that involves sourcing and reviewing the evidence, auditing practice, and reporting the findings. Adapted from NHS Executive. Achieving Effective Practice: The Clinical Effectiveness and Research Information Pack for Nurses, Midwives and Health Visitors, Department of Health, London; 1998.

Figure 2.

An outline for reporting quality improvement and/or changes in clinical practice. The reporting of these projects increases clinical effectiveness by generalizing the knowledge obtained.

Figure 3.

The diffusion process of adoption of an innovation that is communicated through certain channels over time among members of a social system. The typical S shaped curve is characterized by relatively few early adopters, a take off period that triggers rapid adoption, followed by a minority of late adopters. Adapted from Rogers EM. Diffusion of Innovations. New York: Free Press; 2003.