Quality assurance in an adult intensive care unit, Eastern region, Saudi Arabia.
OBJECTIVE
Quality assurance (QA) is an increasingly important element in the administrative management of Intensive Care Unit (ICU). This is not only to improve clinical practices and patient's outcome, but also helps in proper resource utilization. We introduced a comprehensive quality assurance program in ICU at King Abdulaziz National Guard Hospital, Alhasa, Saudi Arabia, based on the existing medical evidence.


METHODS
We identified an already-validated set of quality indicators in intensive care and grouped them in categories of outcome measures (which reflect patient's subsequent health status) and process measures (related to patient-healthcare professional's interaction). Data collection forms were developed for nurses and physicians. Data were reported on monthly basis starting from January 2005, and the first 10 months data are presented.


RESULTS
Three hundred eighty-seven patients were admitted during the study period. Approximately 56.9% had cardiac related diseases, 33.5% had medical ailments, and 9.6% had surgery related issues. There were 54.6% males and 45.4% females. Mean age of the patients was 58.4 +/- 18.3 years. The mean acute physiology and chronic health evaluation II (APACHE-II) score was 13.6 +/- 4.9. Outcome measures were either better or comparable to international data, while adherence to process measures was found to be excellent. Standardized mortality ratio for the duration of study was 0.24 with 95% confidence interval from 0.15-0.36.


CONCLUSIONS
Implementation of QA program is practical in an ICU. Disseminating the quality monitoring information at national level can lead to a broad data base, which can identify the best performing ICUs, thus, leading to bench marking and creating risk adjusted models applicable to local population.
Iqbal
Mobeen
M
Department of Pulmonary and Critical Care Medicine, King Abdulaziz National Guard Hospital, Alhasa, Kingdom of Saudi Arabia.
Rehmani
Rifat
R
Venter
Joan
J
Alaithan
Abdulsalam M
AM
D018806:APACHE; D000328:Adult; D000367:Age Factors; D000368:Aged; D016001:Confidence Intervals; D003422:Critical Care / Q000592:standards* / Q000639:trends; D005260:Female; D019538:Health Care Surveys; D017052:Hospital Mortality / Q000639:trends*; D006772:Hospitals, Military; D006801:Humans; D007362:Intensive Care Units / Q000592:standards*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011336:Probability; D011785:Quality Assurance, Health Care; D012307:Risk Factors; D012529:Saudi Arabia; D012737:Sex Factors