Sabira Valiani1, Romain Rigal1, Henry T Stelfox1, John Muscedere1, Claudio M Martin1, Peter Dodek1, François Lamontagne1, Robert Fowler1, Afshan Gheshmy1, Deborah J Cook1, Alan J Forster1, Paul C Hébert1. 1. Affiliations: University of Ottawa (Valiani, Gheshmy), Ottawa, Ont.; Centre de Recherche du Centre hospitalier de l'Université de Montréal (Rigal), Montréal, Que.; Departments of Critical Care Medicine and Community Health Sciences (Stelfox), University of Calgary, Calgary, Alta.; Department of Medicine (Muscedere), Queen's University, Kingston, Ont.; Lawson Health Research Institute (Martin), London Health Sciences Centre, London, Ont.; Division of Critical Care Medicine and Centre for Health Evaluation & Outcome Sciences (Dodek), St. Paul's Hospital and University of British Columbia, Vancouver, BC; Centre de recherche clinique Étienne-Le Bel (Lamontagne), Université de Sherbrooke, Sherbrooke, Que.; Departments of Medicine and Critical Care Medicine (Fowler), Sunnybrook Hospital, Toronto, Ont.; Departments of Medicine and of Clinical Epidemiology and Biostatistics (Cook), McMaster University, Hamilton, Ont.; Department of Medicine (Forster), University of Ottawa; Clinical Epidemiology Program (Forster), Ottawa Hospital Research Institute, Ottawa, Ont.; Département de Médecine (Hébert), Centre hospitalier de l'Université de Montréal, Hôpital Notre-Dame, Montréal, Que.
Abstract
BACKGROUND: We performed a directed environmental scan to identify and categorize quality indicators unique to critical care that are reported by key stakeholder organizations. METHODS: We convened a panel of experts (n = 9) to identify key organizations that are focused on quality improvement or critical care, and reviewed their online publications and website content for quality indicators. We identified quality indicators specific to the care of critically ill adult patients and then categorized them according to the Donabedian and the Institute of Medicine frameworks. We also noted the organizations' rationale for selecting these indicators and their reported evidence base. RESULTS: From 28 targeted organizations, we identified 222 quality indicators, 127 of which were unique. Of the 127 indicators, 63 (32.5%) were safety indicators and 61 (31.4%) were effectiveness indicators. The rationale for selecting quality indicators was supported by consensus for 58 (26.1%) of the 222 indicators and by published research evidence for 45 (20.3%); for 119 indicators (53.6%), the rationale was not reported or the reader was referred to other organizations' reports. Of the 127 unique quality indicators, 27 (21.2%) were accompanied by a formal grading of evidence, whereas for 52 (40.9%), no reference to evidence was provided. INTERPRETATION: There are many quality indicators related to critical care that are available in the public domain. However, owing to a paucity of rationale for selection, supporting evidence and results of implementation, it is not clear which indicators should be adopted for use. Copyright 2017, Joule Inc. or its licensors.
BACKGROUND: We performed a directed environmental scan to identify and categorize quality indicators unique to critical care that are reported by key stakeholder organizations. METHODS: We convened a panel of experts (n = 9) to identify key organizations that are focused on quality improvement or critical care, and reviewed their online publications and website content for quality indicators. We identified quality indicators specific to the care of critically ill adult patients and then categorized them according to the Donabedian and the Institute of Medicine frameworks. We also noted the organizations' rationale for selecting these indicators and their reported evidence base. RESULTS: From 28 targeted organizations, we identified 222 quality indicators, 127 of which were unique. Of the 127 indicators, 63 (32.5%) were safety indicators and 61 (31.4%) were effectiveness indicators. The rationale for selecting quality indicators was supported by consensus for 58 (26.1%) of the 222 indicators and by published research evidence for 45 (20.3%); for 119 indicators (53.6%), the rationale was not reported or the reader was referred to other organizations' reports. Of the 127 unique quality indicators, 27 (21.2%) were accompanied by a formal grading of evidence, whereas for 52 (40.9%), no reference to evidence was provided. INTERPRETATION: There are many quality indicators related to critical care that are available in the public domain. However, owing to a paucity of rationale for selection, supporting evidence and results of implementation, it is not clear which indicators should be adopted for use. Copyright 2017, Joule Inc. or its licensors.
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