Evaluating Adherence to Guideline-Based Care in Diagnosis and Management of Acute Pancreatitis at an Academic Medical Center - A Quality Improvement Project

Kline, Kevin; Bilal, Mohammad; Marcondes, Felippe O.; Samuel, Ronald; Joshi, Sagar; Allencherril, Ronan; Fischer, Wayne G.; Jenson, W. Tyler; Guturu, Praveen; Sonstein, Lindsay; Parupudi, Sreeram; Olino, Kelly

doi:10.14309/00000434-201810001-00019

Cited by 6 publications

(1 citation statement)

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“…A study performed by Mehmood et al 11 assessed internal medicine resident's knowledge regarding management of AP and noted that it was lacking specifically in initial assessment/risk stratification, role for ERCP, and surgery. A similar study performed by Kline et al 12 looked at 247 patients admitted with acute mild pancreatitis and noted only 6.7% of patients received appropriate IV fluids in the first 24 hours. Thus, there exists a great need to address barriers to adherence to guidelines with a targeted approach.…”

Section: Discussionmentioning

confidence: 85%

Quality Gaps in Management of Acute Pancreatitis

Mohy-ud-din¹,

Deyl²,

Umar

et al. 2021

Pancreas

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Objectives: Acute pancreatitis (AP) is a leading cause of inpatient care among gastrointestinal conditions. Our study compares the management of AP and adherence to guidelines among teaching medicine, nonteaching medicine, and surgical services within the same center.Methods: We performed a retrospective chart review of AP patients admitted to our center between January 2016 and January 2017 and analyzed the clinical and epidemiological data.Results: Of 115 patients, 65% were admitted to medicine (IM), and 35% were admitted to surgery. Mean age was 53.9 (standard deviation [SD], 15) years, and 52% were males; 38.6% (n = 29) of IM patients were prescribed lactated Ringer's solution for fluid resuscitation (mean rate of 153 [SD, 44.98] mL/h on teaching and 113 [SD, 43.56] mL/h on the nonteaching service). Antibiotics were prescribed to 22.6% (n = 17) of IM patients. On the surgical service, 77.5% of patients were prescribed lactated Ringer's solution for fluid resuscitation (mean rate of 108.25 [SD, 1.19] mL/h); 52.5% of patients received antibiotics.Conclusions: Adherence to guidelines for management of AP is inadequate, and nonuniformity exists across different services within the same institution. There is a need for quality improvement initiatives.

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Section: Discussionmentioning

confidence: 85%