RT Journal Article
SR Electronic
T1 An environmental scan of quality indicators in critical care
JF CMAJ Open
FD Canadian Medical Association
SP E488
OP E495
DO 10.9778/cmajo.20150139
VO 5
IS 2
A1 Sabira Valiani
A1 Romain Rigal
A1 Henry T. Stelfox
A1 John Muscedere
A1 Claudio M. Martin
A1 Peter Dodek
A1 François Lamontagne
A1 Robert Fowler
A1 Afshan Gheshmy
A1 Deborah J. Cook
A1 Alan J. Forster
A1 Paul C. Hébert
YR 2017
UL http://www.cmajopen.ca/content/5/2/E488.abstract
AB Background: We performed a directed environmental scan to identify and categorize quality indicators unique to critical care that are reported by key stakeholder organizations.Methods: We convened a panel of experts (n = 9) to identify key organizations that are focused on quality improvement or critical care, and reviewed their online publications and website content for quality indicators. We identified quality indicators specific to the care of critically ill adult patients and then categorized them according to the Donabedian and the Institute of Medicine frameworks. We also noted the organizations' rationale for selecting these indicators and their reported evidence base.Results: From 28 targeted organizations, we identified 222 quality indicators, 127 of which were unique. Of the 127 indicators, 63 (32.5%) were safety indicators and 61 (31.4%) were effectiveness indicators. The rationale for selecting quality indicators was supported by consensus for 58 (26.1%) of the 222 indicators and by published research evidence for 45 (20.3%); for 119 indicators (53.6%), the rationale was not reported or the reader was referred to other organizations' reports. Of the 127 unique quality indicators, 27 (21.2%) were accompanied by a formal grading of evidence, whereas for 52 (40.9%), no reference to evidence was provided.Interpretation: There are many quality indicators related to critical care that are available in the public domain. However, owing to a paucity of rationale for selection, supporting evidence and results of implementation, it is not clear which indicators should be adopted for use.