Quality Indicators in Critical Care
Quality Indicators in Critical Care
Quality Indicators in Critical Care
You also want an ePaper? Increase the reach of your titles
YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.
<strong>Quality</strong> <strong>Indicators</strong> <strong>in</strong> Scottish<br />
<strong>Critical</strong> <strong>Care</strong><br />
Dr Brian Cook
“<strong>Quality</strong> means do<strong>in</strong>g it<br />
right when no-one is<br />
look<strong>in</strong>g.”<br />
Henry Ford
http://www.scotland.gov.uk/Resource/Doc/311667/0098354.pdf<br />
http://www.ics.ac.uk/<strong>in</strong>tensive_care_professional/standards_and_<br />
guidel<strong>in</strong>es/ics_quality_<strong>in</strong>dicators
<strong>Quality</strong> <strong>Indicators</strong> <strong>in</strong> <strong>Critical</strong> <strong>Care</strong><br />
• <strong>Quality</strong> Indicator<br />
– Not just a m<strong>in</strong>imum standard<br />
– Measurable as a means to improve<br />
• Patient <strong>Care</strong><br />
• Patient Safety<br />
• Patient Outcomes<br />
• Efficiency<br />
– Simple Y or N<br />
– Metric: number, %, <strong>in</strong>cidence, etc<br />
• Ideally we collect already<br />
– Support<strong>in</strong>g evidence for use?<br />
– Compatible with ICS QI document<br />
– Realistic and Achievable
Proposals<br />
• Set some m<strong>in</strong>imum yes/no standards<br />
• Choose some measurable quality <strong>in</strong>dicators<br />
• Discuss, Shortlist, Further Work/Literature, etc
Possible Scottish QI’s?<br />
Structure<br />
Item Currently Where?<br />
Collected?<br />
• Computerised Drug Prescrib<strong>in</strong>g y/n N N/A<br />
• Participate <strong>in</strong> SICSAG y/n Y SICSAG<br />
• Medical Staff<strong>in</strong>g Available hrs /week Y Ann report<br />
• Nurse Staff<strong>in</strong>g Ratios WTE:1000bed days Y Ann Report<br />
• Unit QI Team and Strategy <strong>in</strong> place y/n Y SPSP/Local<br />
• HAI surveillance <strong>in</strong> place y/n Y SPSP/WW<br />
• Isolation of <strong>in</strong>fected patients N N/A<br />
• Days at 100% occupancy N WW??
Possible Scottish QI’s?<br />
Process<br />
Item Currently Where?<br />
Collected?<br />
• Use of daily goals y/n Y/N Local<br />
• Multidiscipl<strong>in</strong>ary Ward Rounds ? SPSP?<br />
• Structured handovers y/n N<br />
• <strong>Care</strong> Bundle Audit <strong>in</strong> Place y/n Y SPSP/Local<br />
– Which? More detail? +Ann Report<br />
• % Discharges at night Y WW<br />
– Time? 2200-0659 or 2000-0759<br />
• % Readmission
Possible Scottish QI’s?<br />
Outcome<br />
Item Currently Where?<br />
Collected?<br />
• SMR Y WW<br />
• No. (%) non-cl<strong>in</strong>cal transfers out ? WW+?<br />
• No. (%) early discharges Y WW<br />
• HAI <strong>in</strong>cidence Y WW/HELICS<br />
– MRSA bacteraemia, All Bacteraemias, VAP, CRBSI<br />
• Patient/Family Satisfaction measure N<br />
• % Early enteral nutrition achieved N<br />
– Def<strong>in</strong>ition??, Case mix??<br />
• M+M meet<strong>in</strong>gs held regularly Y Ann report
10 Scottish <strong>Critical</strong> <strong>Care</strong> QI’s
Change language