Measuring clinical information technology in the ICU setting: application in a quality improvement collaborative

Area of Science:

• Healthcare Informatics
• Quality Improvement
• Infection Control

Background:

• Limited tools exist to evaluate the performance of clinical information systems in intensive care units (ICUs).
• Assessing automation and usability is crucial for optimizing ICU information systems.
• A multi-institution quality improvement collaborative provided a setting to test a new performance metric.

Purpose of the Study:

• To develop a survey-based metric assessing the automation and usability of ICU clinical information systems.
• To determine if higher scores on this metric correlate with improved patient outcomes.
• To evaluate the relationship between information system performance and catheter-related bloodstream infection (CRBSI) rates.

Main Methods:

• A cross-sectional study involved medical directors from 19 Michigan ICUs.
• A survey was administered to assess ICU information systems, yielding the Clinical Information Technology (CIT) index.
• Multivariable linear regression analyzed the association between CIT scores and post-intervention CRBSI rates.

Main Results:

• The CIT index is a global measure of ICU information system performance on a 100-point scale.
• A 10-point increase in the CIT score was associated with 4.6 fewer CRBSIs per 1,000 central line days.
• This association was observed in ICUs participating in a quality improvement intervention for one year.

Conclusions:

• A novel instrument, the CIT index, effectively measures ICU information system effectiveness.
• More sophisticated information systems in ICUs are linked to greater reductions in bloodstream infection rates.
• The findings support the integration of advanced clinical information systems for enhanced patient safety.