Publications by authors named "Marion B Robertson"
Evidence-based guidelines exist for the management of patients with acute coronary syndromes (ACS), yet adherence is suboptimal. The Discharge Management of Acute Coronary Syndrome project used a quality improvement approach, with targeted intervention strategies to optimize: prescription of guideline-recommended medications; education regarding lifestyle modifications, including cardiac rehabilitation (CR); and communication between hospital staff, patients, and general practitioners. Hospitals across Australia participated in a quality improvement cycle of audit, feedback, intervention, and reaudit.
View Article and Find Full Text PDFBackground: With the use of medicines being a broad and extensive part of health management, mechanisms to ensure quality use of medicines are essential. Drug usage evaluation (DUE) is an evidence-based quality improvement methodology, designed to improve the quality, safety and cost-effectiveness of drug use. The purpose of this paper is to describe a national DUE methodology used to improve health care delivery across the continuum through multi-faceted intervention involving audit and feedback, academic detailing and system change, and a qualitative assessment of the methodology, as illustrated by the Acute Postoperative Pain Management (APOP) project.
View Article and Find Full Text PDFArticle Synopsis
- - The study aimed to enhance adherence to national guidelines for managing community-acquired pneumonia in Australian emergency departments by promoting the use of appropriate antibiotics and the pneumonia severity index (PSI).
- - A quality improvement methodology was used, which included data collection, evaluation, feedback, and educational initiatives like presentations and prescribing prompts across 37 hospitals, with 26 completing the study phases.
- - Results showed significant improvement in the use of PSI (from 6% to 22-25%) and antibiotic prescribing concordance (from 20% to 29-30%) following the interventions, indicating better alignment with the guidelines.
Article Synopsis
- The study aimed to improve the use of cefotaxime and ceftriaxone (CEFX) in a major teaching hospital by implementing a web-based antimicrobial approval system aligned with national antibiotic guidelines.
- After the intervention, CEFX usage significantly decreased from an average of 38.3 defined daily doses (DDDs) per 1000 bed days to 15.9, while adherence to national guidelines increased from 25% to 51% within five months.
- The results indicate that the system effectively reduced CEFX use and improved guideline compliance, suggesting potential for broader applications and future linked research in electronic prescribing.
Objective: To determine patterns of use of ceftriaxone and cefotaxime (CEFX) in Victorian hospitals and to identify areas for improvement.
Design, Patients And Setting: A concurrent, observational evaluation of CEFX use in patients commencing a course of these drugs between 8 and 14 September, 1999, in 51 Victorian hospitals.
Main Outcome Measures: Proportion of patients treated with CEFX; indications; duration of use; concordance with recommendations of national antibiotic guidelines (Therapeutic guidelines: antibiotic, 10th edition [AG10]).