How to evaluate my ICU’s performance?
Why evaluate my ICU’s performance?
A useful and commonly used definition of quality is often based on the conceptual structure of Donabedian, in which the measurement of health quality is related to structure, process, and results. Thus, making measuring the time of hospitalization and mortality a fundamental part of the evaluation of the quality and overall performance of the ICU, as it reflects on relevant results. Within the same hospital, care variations can be made between different ICUs, and the performance of a single ICU can be evaluated sequentially to highlight progress in the quality of care.
Performing a diagnostic on my ICU: How to measure performance?
Mortality rates, adjusted based on mortality predictions provided by prognostic scoring systems, are used to measure and compare ICU performance. Despite some limitations, scoring systems such as the SAPS3 score are widely validated and have robust calibration, which allows the adequate measurement of mortality while adjusted for the risk of death, guaranteeing fair mortality comparisons. This can be done as analysis over time in a single ICU or compared to others. If adjusted to risk, it means that it may be less subject to the impact of variations in the case-mix. The evaluation of “severity-adjusted mortality rates” may allow recognizing changes in an individual’s performance in the ICU over time, but also identifying institutional deficiencies in the clinical outcome and highlighting target areas for improvement. Scores such as SAPS3 can serve as tools to assess the impact of the new protocol, changes in personnel standards, or organizational changes as part of quality assurance initiatives and improvements.
How should I measure the performance of my ICU?
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