Related Experiment Video
Updated: Jun 12, 2026
Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies
Published on: January 16, 2019
Developing severity adjusted quality measures for intensive care units
Mahi Al Tehewy1, Mostafa El Houssinie, Nahla Abou El Ezz
1Department of Community Medicine, Ain Shams Medical School, Cairo, Egypt. al_tehewy@yahoo.com
Purpose:
Intensive care unit performance evaluation is usually affected by variations in the severity of inpatients' health status. This paper aims, therefore, to standardize two performance measures: intensive care unit survival and length of stay using the Acute Physiology and Chronic Health Evaluation II (APACHE II) severity of illness score.
Design/Methodology/Approach:
A records study in three Ain Shams University Hospital intensive care units, from January 1-December 31, 2003 was carried out to examine illness severity effect using APACHE II, length of stay and survival. Retrospective data were used to model length of stay in days and the survival using the APACHE II score as a predictor. This was followed by a prospective study to monitor the standardized measures in two intensive care units for one year.
Findings:
APACHE II scores predicted length of stay of those who were discharged and control charts for severity-adjusted length of stay were drawn up. The APACHE II score predicted survival for those with APACHE II score >16. The model is significant with a specificity of 89.9 percent while sensitivity was 25 percent. Control charts for severity-adjusted mortality were drawn up to monitor mortality.
Research Limitations/Implications:
Only 60 percent of the files examined in the retrospective part of the study had enough data to calculate APACHE II scores.
Practical Implications:
Standardized APACHE II severity of illness score can monitor intensive care unit length of stay and mortality.
Originality/Value:
The paper underlines the need to implement a standardized measurement system to evaluate intensive care patient outcomes.
Related Concept Videos
01:19Standards of Care II
01:22Standards of Care I
01:30Specialized Care Centers and Settings-II
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:20Acute Kidney Injury V: Interprofessional Care
01:19Guidelines For Measuring Vital Signs
Before taking a patient's vital signs, a nurse would consider and assess the patient's comfort level and ensure appropriate equipment is available.