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November 24 th 2004 Feedback and perspectives

This study presents feedback and perspectives on ICU practices in Belgium, highlighting the need for improved staffing standards, quality analysis, and administrative support for intensivists in the field.

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November 24 th 2004 Feedback and perspectives

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  1. November 24th 2004 Feedback and perspectives

  2. MEMBERS D. Biarent, L. Bossaert, P. Damas, R. De Jongh, L. Huyghens, E. Installé, T. Sottiaux, K. Vandewoude J.P. Alexander, P. Ferdinande, Y. Maetens, Y. Somers

  3. FEEDBACK • WEBSITE • ICU-LANDSCAPE • COMMUNICATION – EDUCATION • NON-INVASIVE VENTILATION

  4. PROSPECTIVES • NOSOCOMIAL INFECTIONS (WIV) • SAPI – BALANCED SCORE CARD • DATA MANAGER

  5. IC College Working Group : ICU landscape in Belgium J.P. AlexanderP. DamasP. FerdinandeP. Reper Ad hoc - L. Huyghens - L. Bossaert IT support R. Tielemans (Uniweb) SIZ Quality Improvement Group (Chair E. Installé)

  6. Methodology • Identification of all ICU directors in Belgium • Creation of website (www.iccollege.be)  questionnaire  individual password • Data collection june 1st, 2002  july 31st, 2003 • Absolute commitment for strict confidentiality • Data cleaning (JPA & PF) • Report of questions answered by at least 25 % of the participants

  7. Response rate : 58 of 107 ICU directors (= 54 %) 988 ICU beds Report • General information • Staffing • Architecture • Bedside monitoring • Communication systems • Fire safety • Central services

  8. Parameters of activity Number of admissions / ICU / year 2000 1151,8 ± 881,5 (791/306-3993) 2001 1136,9 ± 850,6 (839/384-3767) 2002 1094,47 ± 870,6 (792/303-3995) Number of admissions / ICU bed / year 2000 75,8 ± 24,2 (70,8/43,7-145,2) 2001 74,9 ± 22,2 (71,6/44,3-140,7) 2002 74,7 ± 24,2 (70,4/33,7-134,2) ICU LOS days 2000 4,16 ± 1,0 (4,2/1,92-6,5) 2001 4,17 ± 1,1 (4,0/1,89-7,9) 2002 4,32 ± 1,2 (4,2/2,15-8,2) Occupancy rate % 2000 83,3 ± 8,1 (82,4/65-100) 2001 82,9 ± 8,2 (83/67-98) 2002 82,9 ± 10,6 (83/58-100)

  9. Parameters of activity Year Readmissions % ICU mortality % 2000 5,3 ± 3,3 (4,65/1-14) 8,6 ± 4,3 (8,0/0-21) 2001 4,8 ± 3,6 (3,8/1-15) 8,9 ± 4,1 (8,1/3,9-23) 2002 5,0 ± 3,5 (4,55/0,7-15) 9,2 ± 4,2 (9/3,5-23)

  10. Conclusions • Intensive Care Medicine in Belgium is a heterogeneous activity (staff and admitted patients) • Both medical and nursing staffing are at the lower edge of the international standards • Quality analysis of ICU processes can be done in the perspective of the case mix and outcome parameters, but administrative support for the intensivist in the field is highly desirable

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