{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T19:04:53Z","timestamp":1790881493088,"version":"4.1.0"},"reference-count":22,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T00:00:00Z","timestamp":1743552000000},"content-version":"unspecified","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Queen\u2019s University Department of Medicine Research Award"},{"name":"SEAMO Quality Improvement Project Fund"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Qual"],"accepted":{"date-parts":[[2025,3,22]]},"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>\n                     <jats:italic>Staphylococcus aureus<\/jats:italic> bacteraemia had a higher mortality rate than average at Kingston Health Sciences Centre (KHSC). Infectious diseases specialist consultation has been shown to improve outcomes for <jats:italic>S. aureus<\/jats:italic> bacteraemia by increasing adherence to evidence-based care practices. Yet, infectious disease specialists were not involved in many cases at KHSC.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>To improve adherence to evidence-based care practices by increasing the proportion of patients with <jats:italic>S. aureus<\/jats:italic> bacteraemia who receive a formal infectious diseases consultation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Interventions<\/jats:title>\n                  <jats:p>A multimodal intervention consisting of (1) daily automated email of positive blood culture results to the infectious diseases team; (2) standardisation of prompts attached to positive blood culture results on the electronic medical record; (3) policy of mandatory infectious diseases consultation and (4) education of resident physicians.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Implementation and evaluation<\/jats:title>\n                  <jats:p>The outcome measure was adherence to evidence-based care practices, defined as echocardiography, repeating blood cultures and treatment with a first-line antibiotic. A secondary outcome measure was 90-day mortality. The process measure was the proportion of patients receiving formal infectious diseases consultation. A balancing measure was hospital length of stay. All measures were monitored semimonthly using statistical process control charts for time periods before and after intervention.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There were 171 and 186 patients with <jats:italic>S. aureus<\/jats:italic> bacteraemia in the preintervention and postintervention period, respectively. Between these two periods, the proportion of those who received evidence-based care practices increased from 73% to 82% (p=0.031) and demonstrated special cause variation. Mortality changed from 29% to 24% (p=0.400). The proportion of patients receiving an infectious diseases consultation increased from 47% to 90% (p&lt;0.001) and demonstrated special cause variation. The median (IQR) length of stay was 18 (11\u201330) days and 17 (11\u201342) days in the preintervention and postintervention period, respectively (p=0.442).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>A multimodal intervention that implemented mandatory infectious diseases consultation significantly improved evidence-based care practices for <jats:italic>S. aureus<\/jats:italic> bacteraemia.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjoq-2024-003243","type":"journal-article","created":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T02:31:31Z","timestamp":1743647491000},"page":"e003243","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Increasing evidence-based care practices for patients with <i>Staphylococcus aureus<\/i> bacteraemia through required infectious diseases consultation in a tertiary care hospital: a quality improvement initiative"],"prefix":"10.1136","volume":"14","author":[{"given":"Arunima Soma","family":"Dalai","sequence":"first","affiliation":[{"name":"Department of Medicine, Queen\u2019s University, Kingston, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma B","family":"Monti","sequence":"additional","affiliation":[{"name":"School of Medicine, Queen\u2019s University, Kingston, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raghad","family":"Mallesho","sequence":"additional","affiliation":[{"name":"Internal Medicine Residency Program, Queen\u2019s University, Kingston, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Obeda","sequence":"additional","affiliation":[{"name":"Internal Medicine Residency Program, Queen\u2019s University, Kingston, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald A","family":"Evans","sequence":"additional","affiliation":[{"name":"Department of Medicine, Queen\u2019s University, Kingston, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santiago","family":"Perez-Patrigeon","sequence":"additional","affiliation":[{"name":"Department of Medicine, Queen\u2019s University, Kingston, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Medicine, Queen\u2019s University, Kingston, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge L","family":"Martinez-Cajas","sequence":"additional","affiliation":[{"name":"Department of Medicine, Queen\u2019s University, Kingston, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prameet M","family":"Sheth","sequence":"additional","affiliation":[{"name":"Department of Pathology and Molecular Medicine, Kingston 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