开发和2025年对日本成人重症监护的质量指标进行重新评估:修改后的RAND/UCLA Delphi研究
Junji Kumasawa1,2, Hiroshi Okamoto3, Takaki Naito4
1Department of Critical Care Medicine, Sakai City Medical Cente, 1-1-1 Ebaraji-Cho, Nishi-Ku, Sakai, Osaka, 593-8304, Japan. jkumakumakuma@hotmail.com.
Journal of intensive care
|February 10, 2026
概括
2025年重新评估更新了日本的重症监护病房 (ICU) 质量指标 (QI),确保了持续质量改进和成人ICU的国家基准测试的相关性.
科学领域:
- 关键护理医学 关键护理医学
- 改善医疗保健质量 改善医疗保健质量
- 医疗保健服务研究 医疗服务研究
背景情况:
- 为日本的成人重症监护室 (ICU) 建立了一套全面的,基于证据的质量指标 (QI).
- 认识到需要定期更新QI,因为临床重症监护的证据和实践不断变化.
- 在2025年启动正式的重新评估,以确认2017-2018年开发的日本ICUQI核心集的有效性和更新.
研究的目的:
- 为日本的重症监护病房开发和更新一套可行的,适应环境的质量指标.
- 确认现有的ICU质量指标的当前有效性和相关性.
- 建立一个全国基准测试和日本ICU的持续质量改善的基础.
主要方法:
- 采用修改后的RAND/UCLA适当性方法,涉及多学科专家小组.
- 进行了系统的文献审查,并分析了主要的临床指南,以生成候选质量指标.
- 使用了三轮评级和共识过程,包括面对面的会议,以完善和最终确定质量指标集.
主要成果:
- 确定了一套最初的44个候选质量指标.
- 2018年共识过程产生了一套38个质量指标 (13个结构,10个过程,15个结果).
- 2025年重新评估确认了37个指标,将其中一个重新归类为不确定的,并添加了一个新的适当指标,保持了38个指标的核心集.
结论:
- 使用严格的方法来开发和更新一个可行的和与上下文相关的日本ICU QI集.
- 更新后的38个质量指标的核心集为质量改进举措提供了坚实的基础.
- 完成的质量指标被认为是适合和相关的日本ICU设置,支持国家基准测试.
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