Quality indicators for patients with traumatic brain injury in European intensive care units: a CENTER-TBI study.

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Huijben, Jilske A (författare)

Quality indicators for patients with traumatic brain injury in European intensive care units : a CENTER-TBI study.

Artikel/kapitelEngelska2020

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2020-03-04
Springer Science and Business Media LLC,2020
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LIBRIS-ID:oai:DiVA.org:umu-171372
https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-171372URI
https://doi.org/10.1186/s13054-020-2791-0DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:143242572URI

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Språk:engelska
Sammanfattning på:engelska

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BACKGROUND: The aim of this study is to validate a previously published consensus-based quality indicator set for the management of patients with traumatic brain injury (TBI) at intensive care units (ICUs) in Europe and to study its potential for quality measurement and improvement.METHODS: Our analysis was based on 2006 adult patients admitted to 54 ICUs between 2014 and 2018, enrolled in the CENTER-TBI study. Indicator scores were calculated as percentage adherence for structure and process indicators and as event rates or median scores for outcome indicators. Feasibility was quantified by the completeness of the variables. Discriminability was determined by the between-centre variation, estimated with a random effect regression model adjusted for case-mix severity and quantified by the median odds ratio (MOR). Statistical uncertainty of outcome indicators was determined by the median number of events per centre, using a cut-off of 10.RESULTS: A total of 26/42 indicators could be calculated from the CENTER-TBI database. Most quality indicators proved feasible to obtain with more than 70% completeness. Sub-optimal adherence was found for most quality indicators, ranging from 26 to 93% and 20 to 99% for structure and process indicators. Significant (p < 0.001) between-centre variation was found in seven process and five outcome indicators with MORs ranging from 1.51 to 4.14. Statistical uncertainty of outcome indicators was generally high; five out of seven had less than 10 events per centre.CONCLUSIONS: Overall, nine structures, five processes, but none of the outcome indicators showed potential for quality improvement purposes for TBI patients in the ICU. Future research should focus on implementation efforts and continuous reevaluation of quality indicators.TRIAL REGISTRATION: The core study was registered with ClinicalTrials.gov, number NCT02210221, registered on August 06, 2014, with Resource Identification Portal (RRID: SCR_015582).

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Neurologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Neurology hsv//eng
Benchmarking
Intensive care units
Quality indicators
Quality of health care
Traumatic brain injuries

Biuppslag (personer, institutioner, konferenser, titlar ...)

Wiegers, Eveline J A (författare)
Ercole, Ari (författare)
de Keizer, Nicolette F (författare)
Maas, Andrew I R (författare)
Steyerberg, Ewout W (författare)
Citerio, Giuseppe (författare)
Wilson, Lindsay (författare)
Polinder, Suzanne (författare)
Nieboer, Daan (författare)
Menon, David (författare)
Lingsma, Hester F (författare)
van der Jagt, Mathieu (författare)
Brorsson, CamillaUmeå universitet,Anestesiologi och intensivvård(Swepub:umu)brca0001 (bidragsgivare)
Sundström, NinaUmeå universitet,Institutionen för strålningsvetenskaper(Swepub:umu)nian0004 (bidragsgivare)
Umeå universitetAnestesiologi och intensivvård (creator_code:org_t)

Sammanhörande titlar

Ingår i:Critical Care: Springer Science and Business Media LLC24:11364-85351466-609X

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Av författaren/redakt...: Huijben, Jilske ...; Wiegers, Eveline ...; Ercole, Ari; de Keizer, Nicol ...; Maas, Andrew I R; Steyerberg, Ewou ...; visa fler...; Citerio, Giusepp ...; Wilson, Lindsay; Polinder, Suzann ...; Nieboer, Daan; Menon, David; Lingsma, Hester ...; van der Jagt, Ma ...; Brorsson, Camill ...; Sundström, Nina; visa färre...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Neurologi

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Av lärosätet: Umeå universitet; Karolinska Institutet

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