Quality Improvement

How does one measure quality in the healthcare context, is it patients outcomes, length of stay, reduced infection rates?  We define quality improvement as a continuous process of Benchmarking. We termed these processes as analyse, apply and achieve.

To establish how well or badly your organisation is doing and to identify areas for improvement, it pays to compare your organisation with its best performing peers. Most intensive care units use either one or a combination of severity scoring systems to benchmark their clinical performance. Provided ICUs uses the same Benchmarking methodology such as the APACHE II or UK ICNARC APACHE II, it does not matter which yardstick is applied, so long as the ICU is comparing different time periods.

Discussions on ICU audit usually starts off in a turgid and formal matter – e.g. auditing the structure, process and outcome of an ICU. We like to start by stating the aim of audit as "the identification of problems, the resolution of which, will improve the care of patients in the ICU". Auditing Intensive Care has been bedevilled by the different case-mix and severity of illness within an ICU over different time periods and between different ICUs. Advances in severity of illness scoring systems and risk stratification over the past 15 years make such comparisons possible with a high degree of accuracy. Estimation of admission risk of patients treated in an ICU allows the computation of the Standardised Mortality Ratio (SMR) which is obtained by dividing the Actual Hospital Mortality by the Expected Mortality for a patient cohort.

MEDTRACK clinical audit module not only gives you the overall SMR of your unit, it will analyse and present to you SMRs of different patient cohorts.
 
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