Do Quality Improvement Collaboratives Improve Antimicrobial Prophylaxis in Surgical Patients?
IN RESPONSE: We thank Dr. Liu and colleagues for their comments regarding our recent article. They made several statements about our results that readers less familiar with the article may find misleading. Although both groups showed improvements in many aspects of antimicrobial prophylaxis, differences in the extent of improvement between the 2 groups on any indicator were not significant. Our conclusion is correct in this regard. Our study was designed to examine the absolute difference in change between the 2 groups, not the relative difference in change; thus, the proper statistic to evaluate the effect of participation in the collaborative group for the “all-or-none” indicator shows a 6.3% (95% CI, −7.3% to 19.8%) greater improvement in the active intervention. We agree that improvement interventions are complex social processes that should be theory-based and explained in context by using evaluation models drawn from social science (1, 2). However, we disagree with the statement
