title: Automatic quality improvement reports in the intensive care unit: One step closer toward meaningful use.
abstract: OBJECTIVE
  To examine the feasibility and validity of electronic generation of quality metrics in the intensive care unit (ICU).
  
  
  METHODS
  This minimal risk observational study was performed at an academic tertiary hospital. The Critical Care Independent Multidisciplinary Program at Mayo Clinic identified and defined 11 key quality metrics. These metrics were automatically calculated using ICU DataMart, a near-real time copy of all ICU electronic medical record (EMR) data. The automatic report was compared with data from a comprehensive EMR review by a trained investigator. Data was collected for 93 randomly selected patients admitted to the ICU during April 2012 (10% of admitted adult population). This study was approved by the Mayo Clinic Institution Review Board.
  
  
  RESULTS
  All types of variables needed for metric calculations were found to be available for manual and electronic abstraction, except information for availability of free beds for patient-specific time-frames. There was 100% agreement between electronic and manual data abstraction for ICU admission source, admission service, and discharge disposition. The agreement between electronic and manual data abstraction of the time of ICU admission and discharge were 99% and 89%. The time of hospital admission and discharge were similar for both the electronically and manually abstracted datasets. The specificity of the electronically-generated report was 93% and 94% for invasive and non-invasive ventilation use in the ICU. One false-positive result for each type of ventilation was present. The specificity for ICU and in-hospital mortality was 100%. Sensitivity was 100% for all metrics.
  
  
  CONCLUSIONS
  Our study demonstrates excellent accuracy of electronically-generated key ICU quality metrics. This validates the feasibility of automatic metric generation.
authors.affiliation: Mikhail A Dziadzko, Charat Thongprayoon, Adil Ahmed, Ing C Tiong, Man Li, Daniel R Brown, Brian W Pickering, Vitaly Herasevich, Multidisciplinary Epidemiology and Translational Research in Intensive Care, Mayo Clinic, Rochester, MN 55905, United States.
authors.forename: Mikhail A
authors.initials: MA
authors.lastname: Dziadzko
authors.affiliation: Mikhail A Dziadzko, Charat Thongprayoon, Adil Ahmed, Ing C Tiong, Man Li, Daniel R Brown, Brian W Pickering, Vitaly Herasevich, Multidisciplinary Epidemiology and Translational Research in Intensive Care, Mayo Clinic, Rochester, MN 55905, United States.
authors.forename: Charat
authors.initials: C
authors.lastname: Thongprayoon
authors.affiliation: Mikhail A Dziadzko, Charat Thongprayoon, Adil Ahmed, Ing C Tiong, Man Li, Daniel R Brown, Brian W Pickering, Vitaly Herasevich, Multidisciplinary Epidemiology and Translational Research in Intensive Care, Mayo Clinic, Rochester, MN 55905, United States.
authors.forename: Adil
authors.initials: A
authors.lastname: Ahmed
authors.affiliation: Mikhail A Dziadzko, Charat Thongprayoon, Adil Ahmed, Ing C Tiong, Man Li, Daniel R Brown, Brian W Pickering, Vitaly Herasevich, Multidisciplinary Epidemiology and Translational Research in Intensive Care, Mayo Clinic, Rochester, MN 55905, United States.
authors.forename: Ing C
authors.initials: IC
authors.lastname: Tiong
authors.affiliation: Mikhail A Dziadzko, Charat Thongprayoon, Adil Ahmed, Ing C Tiong, Man Li, Daniel R Brown, Brian W Pickering, Vitaly Herasevich, Multidisciplinary Epidemiology and Translational Research in Intensive Care, Mayo Clinic, Rochester, MN 55905, United States.
authors.forename: Man
authors.initials: M
authors.lastname: Li
authors.affiliation: Mikhail A Dziadzko, Charat Thongprayoon, Adil Ahmed, Ing C Tiong, Man Li, Daniel R Brown, Brian W Pickering, Vitaly Herasevich, Multidisciplinary Epidemiology and Translational Research in Intensive Care, Mayo Clinic, Rochester, MN 55905, United States.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Brown
authors.affiliation: Mikhail A Dziadzko, Charat Thongprayoon, Adil Ahmed, Ing C Tiong, Man Li, Daniel R Brown, Brian W Pickering, Vitaly Herasevich, Multidisciplinary Epidemiology and Translational Research in Intensive Care, Mayo Clinic, Rochester, MN 55905, United States.
authors.forename: Brian W
authors.initials: BW
authors.lastname: Pickering
authors.affiliation: Mikhail A Dziadzko, Charat Thongprayoon, Adil Ahmed, Ing C Tiong, Man Li, Daniel R Brown, Brian W Pickering, Vitaly Herasevich, Multidisciplinary Epidemiology and Translational Research in Intensive Care, Mayo Clinic, Rochester, MN 55905, United States.
authors.forename: Vitaly
authors.initials: V
authors.lastname: Herasevich
keywords: Automatic; Critical care; Datamart; Electronic medical record; Health care; Information processing; Intensive care; Quality indicators