1 / 10

National Institute for Public Health and Environment

Naam van de presentator(en) | datum. Development and Evaluation of Quality Indicators in the Intensive Care Unit: Preliminary Results Maartje de Vos, Wilco C.Graafmans | 26 June 2006 Centre for prevention and health services research Email:maartje.de.vos@rivm.nl.

wray
Download Presentation

National Institute for Public Health and Environment

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Naam van de presentator(en) | datum Development and Evaluation of Quality Indicators in the Intensive Care Unit: Preliminary Results Maartje de Vos, Wilco C.Graafmans | 26 June 2006 Centre for prevention and health services research Email:maartje.de.vos@rivm.nl National Institute for Public Health and Environment

  2. Outline presentation • Background • Study methods • Results: selected set of quality indicators for ICU • Results: variation among ICUs

  3. Background • Growing need/expectation to measure quality of care in the Netherlands, e.g. at ICUs • Measurement by quality Indicators: screening tool to identify potential sub-optimal clinical care • Different types of indicators (Donabedian):structure, process, and outcome indicators • Learn and improve from indicators by comparing results with reference values and comparison among hospitals

  4. Objectives • Objectives: 1) to develop a set of quality indicators for the ICU and, 2) to evaluate the use of these indicators in a pilot study • Quality indicators for internal use, to stimulate improvement of quality of care at ICUs • Supported by the Dutch Health Care Inspectorate and the Association of Medical Specialists

  5. Development of indicators • Methods • Literature search: 50 indicators • Expert opinion:12 indicators • Working group: Dutch Society of Intensive Care (NVIC) • Selection based on relevance for quality, feasibility, and potential for improvement • By consensus among experts 12 indicators were selected

  6. Set of indicators Case mix age,gender • Structure • Intensivist availability • Nurse to patiënt ratio • Medication error prevention policy • Registration of patiënt/family satisfaction • Process • ICU lenght of stay • Duration of mechanical ventilation • Frequency of interclinical transport • Frequency 100% occupation • Glucose dysregulation • Outcome • Mortality • Incidence of severe decubitus • Frequency of unplanned extubation

  7. Pilot Study • Aim: • to evaluate the feasibility of the registration of the indicators • To obtain data for analyses • Methods • 18 ICUs • Registration during 6 months • Data collected in a national database (NICE) • Site visits, interviews • Questionnaire (time te register, workload and perceived validity and reliability)

  8. 46%< 30 min 17%> 60 min Pilot Study • Results (feasibility) • Time to register per day • 46% < 30 min • 37% 30-60 min • 17% > 60 min • Workload was acceptable for 86% of the respondents • Interclinical transport and unplanned extubation were the least reliable collected items • > 80% supported further implementation for 9 indicators Investment of time to register 37% 30-60

  9. Results (examples of crude data) • 7682 admissions, 31849 treatment days CONCEPT

  10. Conclusion • A set of 12 indicators was defined: 4 structure, 5 process and 3 outcome • Workload of registration was acceptable but computer assistance is necessary • Crude data of scores of indicators discriminate among hospitals • Future plans: • Adjusting the set for implementation • Analysis for interpretation and feed back • Research on case mix

More Related