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Related Experiment Videos

Developing and pilot testing quality indicators in the intensive care unit.

Peter J Pronovost1, Sean M Berenholtz, Koni Ngo

  • 1Department of Anesthesiology/Critical Care Medicine, Surgery, Health Policy and Management, The Johns Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore, MD 21287, USA. ppronovo@jhmi.edu

Journal of Critical Care
|November 5, 2003
PubMed
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Measuring intensive care unit (ICU) quality of care is feasible and essential for improving patient outcomes. Implementing quality measures can reduce mortality, morbidity, and length of stay in ICUs.

Area of Science:

  • Critical Care Medicine
  • Healthcare Quality Improvement
  • Health Services Research

Background:

  • Measuring quality of care in intensive care units (ICUs) is crucial for identifying areas of improvement.
  • Existing quality measures may not always be practical for widespread implementation.
  • Assessing current performance is key to understanding the potential for quality enhancement.

Purpose of the Study:

  • To develop and implement practical, valid, and reliable quality of care measures for ICUs.
  • To estimate the potential for quality improvement based on current performance data.
  • To assess the feasibility of a broad set of ICU quality measures in a hospital cohort.

Main Methods:

  • Included 13 adult medical and surgical ICUs in urban teaching and community hospitals.

Related Experiment Videos

  • Developed and pilot-tested three data collection tools: Team Leader, Daily Rounding, and Infection Control forms.
  • Utilized published efficacy estimates to determine the clinical and economic impact of current performance on key quality indicators.

    • Main Results:

    • Significant variation in performance was observed across and within the 13 ICUs.
    • Median adherence rates included: 64% for appropriate sedation, 67% for elevating head of bed, 89% for peptic ulcer disease (PUD) prophylaxis, and 87% for deep venous thrombosis (DVT) prophylaxis.
    • The median rate of appropriate blood transfusion was only 33%, indicating substantial room for improvement.

    Conclusions:

    • Measuring ICU performance is a prerequisite for improving quality of care.
    • Implementing a comprehensive set of ICU quality measures is feasible in a hospital setting.
    • Enhancing performance on these quality indicators holds the potential to reduce patient mortality, morbidity, and ICU length of stay.