Forskning
Udskriv Udskriv
Switch language
Rigshospitalet - en del af Københavns Universitetshospital
Udgivet

Development of a quality indicator set to measure and improve quality of ICU care for patients with traumatic brain injury

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. Influenza and associated co-infections in critically ill immunosuppressed patients

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Important methodological flaws in the recently published clinical prediction model the REMEMBER score

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Continuous EEG Monitoring in a Consecutive Patient Cohort with Sepsis and Delirium

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Transcerebral exchange kinetics of large neutral amino acids during acute inspiratory hypoxia in humans

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Delayed cerebral ischaemia in patients with aneurysmal subarachnoid haemorrhage: Functional outcome and long-term mortality

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Soluble ST2 links inflammation to outcome after subarachnoid hemorrhage

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  5. High-dose naloxone, an experimental tool uncovering latent sensitisation: pharmacokinetics in humans

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  • Jilske A Huijben
  • Eveline J A Wiegers
  • Nicolette F de Keizer
  • Andrew I R Maas
  • David Menon
  • Ari Ercole
  • Giuseppe Citerio
  • Fiona Lecky
  • Lindsay Wilson
  • Maryse C Cnossen
  • Suzanne Polinder
  • Ewout W Steyerberg
  • Mathieu van der Jagt
  • Hester F Lingsma
  • Delphi panel
  • Kirsten Møller (Medlem af forfattergruppering)
Vis graf over relationer

BACKGROUND: We aimed to develop a set of quality indicators for patients with traumatic brain injury (TBI) in intensive care units (ICUs) across Europe and to explore barriers and facilitators for implementation of these quality indicators.

METHODS: A preliminary list of 66 quality indicators was developed, based on current guidelines, existing practice variation, and clinical expertise in TBI management at the ICU. Eight TBI experts of the Advisory Committee preselected the quality indicators during a first Delphi round. A larger Europe-wide expert panel was recruited for the next two Delphi rounds. Quality indicator definitions were evaluated on four criteria: validity (better performance on the indicator reflects better processes of care and leads to better patient outcome), feasibility (data are available or easy to obtain), discriminability (variability in clinical practice), and actionability (professionals can act based on the indicator). Experts scored indicators on a 5-point Likert scale delivered by an electronic survey tool.

RESULTS: The expert panel consisted of 50 experts from 18 countries across Europe, mostly intensivists (N = 24, 48%) and neurosurgeons (N = 7, 14%). Experts agreed on a final set of 42 indicators to assess quality of ICU care: 17 structure indicators, 16 process indicators, and 9 outcome indicators. Experts are motivated to implement this finally proposed set (N = 49, 98%) and indicated routine measurement in registries (N = 41, 82%), benchmarking (N = 42, 84%), and quality improvement programs (N = 41, 82%) as future steps. Administrative burden was indicated as the most important barrier for implementation of the indicator set (N = 48, 98%).

CONCLUSIONS: This Delphi consensus study gives insight in which quality indicators have the potential to improve quality of TBI care at European ICUs. The proposed quality indicator set is recommended to be used across Europe for registry purposes to gain insight in current ICU practices and outcomes of patients with TBI. This indicator set may become an important tool to support benchmarking and quality improvement programs for patients with TBI in the future.

OriginalsprogEngelsk
TidsskriftCritical care (London, England)
Vol/bind23
Udgave nummer1
Sider (fra-til)95
ISSN1466-609X
DOI
StatusUdgivet - 22 mar. 2019

ID: 59034201