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Evaluation of Quality Indicators in an Indian Intensive Care Unit Using "CHITRA" Database
Kiran Kumar Gudivada1, Bhuvana Krishna1, Sampath Sriram1
1Department of Critical Care Medicine, St. John's Medical College and Hospital, Bengaluru, Karnataka, India.
Summary
This study reports key quality indicators (QIs) for Indian Intensive Care Units (ICUs) using the CHITRA tool. Findings provide benchmarks for critical care quality improvement in India.
Area of Science:
- Critical Care Medicine
- Healthcare Quality Improvement
- Health Informatics
Background:
- Quality indicators (QIs) are vital for maintaining high standards of care for critically ill patients.
- The Indian Society of Critical Care Medicine developed benchmarks and the CHITRA tool for electronic data capture in Indian ICUs.
Purpose of the Study:
- To report on various quality indicators within an Indian Intensive Care Unit (ICU).
- To utilize the Customized Health in Intensive Care Trainable Research and Analysis (CHITRA) database for QI assessment.
Main Methods:
- Data from 2642 patients admitted to the ICU between October 2015 and January 2017 were analyzed.
- Key QIs assessed included standardized mortality ratio (SMR), length of ICU stay (LOS-ICU), pressure ulcer (PU) rate, patient fall rate (FR), ICU readmission rate, reintubation rate, ventilator-associated condition (VAC), central line-associated bloodstream infection (CLABSI), catheter-associated urinary tract infection (CAUTI), and iatrogenic pneumothorax rate.
Main Results:
- Median LOS-ICU was 3 days, with an SMR of 1.1.
- Reported rates included pneumothorax (2.6/1000), PU (4.1/1000), FR (0.3/1000), readmission (0.7%), and reintubation (3.5%).
- Infection rates: VAC (8.5/1000 ventilator days), CLABSI (23/1000 catheter days), and CAUTI (3.1/1000 catheter days).
Conclusions:
- The study successfully evaluated a comprehensive set of QIs in a mixed ICU.
- The CHITRA database proved effective for assessing quality indicators in a tertiary hospital setting.