title: An electronic tool for visual feedback to monitor the adherence to quality indicators in intensive care medicine.
abstract: Evidence-based medicine is often inadequately implemented in intensive care units (ICU); the aim of this study was to improve its implementation via a technical feedback system, using key performance indicators (KPI). The study evaluated 205 patients treated in a cardiac surgical ICU  over a 6-month period (3 months before and 3 months after implementation of the feedback system). KPI adherence rates for sedation, delirium and pain monitoring, and completion of a weaning protocol before and after the implementation of the feedback system, were compared. Adherence rates  for pain and delirium monitoring, and implementation of the weaning protocol, were significantly increased by the intervention. Adherence to KPIs for sedation, which were high at baseline, could not be further improved. Daily display of KPI implementation had a positive effect on adherence  to standard operating procedures. Adherence to guidelines may be improved by using this feedback system as part of the clinical routine.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Campus Virchow-Klinikum and Campus Charité Mitte, Charité-University Medicine Berlin, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Kastrup
authors.forename: M J
authors.initials: MJ
authors.lastname: Nolting
authors.forename: R
authors.initials: R
authors.lastname: Ahlborn
authors.forename: J-P
authors.initials: JP
authors.lastname: Braun
authors.forename: H
authors.initials: H
authors.lastname: Grubitzsch
authors.forename: K-D
authors.initials: KD
authors.lastname: Wernecke
authors.forename: C
authors.initials: C
authors.lastname: Spies
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures / Q000401:mortality / Q000592:standards; D003422:Critical Care / Q000592:standards*; D004582:Electronics, Medical / Q000295:instrumentation*; D056228:Feedback, Sensory; D005260:Female; D019983:Guideline Adherence / Q000592:standards*; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D015999:Multivariate Analysis; D019984:Quality Indicators, Health Care / Q000592:standards*; D012121:Respiration, Artificial