QI falters after trial fails to reduce mortality after abdominal surgery

A quality improvement (QI) programme aimed at reducing mortality after emergency abdominal surgery had no effect, a large randomised trial in the NHS has shown.1

Just as many patients died in the hospitals implementing the quality improvements as in those providing usual care, the EPOCH (enhanced perioperative care for high risk patients) trial showed. The result casts a cloud over efforts to improve outcomes in healthcare by using the formal and systematic methods known as QI.

Rupert Pearse, professor and consultant in intensive care at Queen Mary University of London and senior author, said: “QI programmes are not a quick and easy solution to improving …