title: Quality Improvement in Critical Care: Selection and Development of Quality Indicators.
abstract: Background. Caring for critically ill patients is complex and resource intensive. An approach to monitor and compare the function of different intensive care units (ICUs) is needed to optimize outcomes for patients and the health system as a whole. Objective. To develop and implement quality indicators for comparing ICU characteristics and performance within and between ICUs and regions over time. Methods. Canadian jurisdictions with established ICU clinical databases were invited to participate in an iterative series of face-to-face meetings, teleconferences, and web conferences. Eighteen adult intensive care units across 14 hospitals and 5 provinces participated in the process. Results. Six domains of ICU function were identified: safe, timely, efficient, effective, patient/family satisfaction, and staff work life. Detailed operational definitions were developed for 22 quality indicators. The feasibility was demonstrated with the collection of 3.5 years of data. Statistical process control charts and graphs of composite measures were used for data display and comparisons. Medical and nursing leaders as well as administrators found the system to be an improvement over prior methods. Conclusions. Our process resulted in the selection and development of 22 indicators representing 6 domains of ICU function. We have demonstrated the feasibility of such a reporting system. This type of reporting system will demonstrate variation between units and jurisdictions to help identify and prioritize improvement efforts.
authors: Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada T2V 1P9.
authors: Carla A
authors: 0000-0003-4952-9768
authors: CA
authors: Chrusch
authors: Department of Medicine, University of Western Ontario, London, ON, Canada N6A 4G5.
authors: Claudio M
authors: CM
authors: Martin
authors: The Quality Improvement in Critical Care Project, Canada.
authors: The Quality Improvement In Critical Care
authors: TQ
authors: Project
mesh_terms: D003422:Critical Care / Q000592:standards*; D006801:Humans; D019984:Quality Indicators, Health Care