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Updated: Oct 1, 2025

Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex

Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex

Published on: July 4, 2018

Quality Indicators for High-Need Patients: a Systematic Review.

Todd Schneberk¹, Maria Bolshakova², Kylie Sloan²

¹Gehr Center for Health Systems Science and Innovation, Keck School of Medicine, University of Southern California, GNH 1011, 1200 N State Street Rm 1011, Los Angeles, CA, 90033, USA. todd.schneberk@med.usc.edu.

Journal of General Internal Medicine

|March 9, 2022

Summary

This systematic review identified over 1700 quality indicators for high-need patients. However, few indicators address social determinants of health or behavioral factors, highlighting a need for further research.

Keywords:

complex patients frequent utilization high utilizer high-need indicator quality

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Last Updated: Oct 1, 2025

Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex

Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex

Published on: July 4, 2018

Area of Science:

Healthcare Quality Improvement
Patient-Centered Care
Health Services Research

Background:

Healthcare systems are developing programs for high-need patients with complex conditions and social needs.
There is limited understanding of quality indicators to guide care improvement for this population.
This study systematically reviewed existing quality indicators for high-need patients.

Approach:

Conducted a systematic review searching PubMed, CINAHL, EMBASE, ECRI, GIN, and Google Scholar.
Included studies suggesting, evaluating, or utilizing quality indicators for high-need patients.
Critically appraised indicators based on development, endorsement, adoption, and feasibility, standardizing by patient subgroups.

Key Points:

Identified over 1700 quality indicators from 53 studies.
Indicator scope varied from specific criteria (e.g., "annual eye exam") to broad categories (e.g., "care coordination").
Indicators included disease-specific, condition-independent, and mixed types.

Conclusions:

Existing quality indicators for high-need patients are numerous but heterogeneous.
Few current indicators incorporate social determinants of health or behavioral factors.
Further research is essential to develop comprehensive quality indicators addressing patient risk factors.