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Int J Cardiol. 2018 Jun 1;260:219-225. doi: 10.1016/j.ijcard.2018.02.113. Epub 2018 Feb 28.

Systematic review and directors survey of quality indicators for the cardiovascular intensive care unit.

Author information

1
Division of Pulmonary and Critical Care, Cedars-Sinai Medical Center, Los Angeles, CA, United States; Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, United States. Electronic address: michael.j.goldfarb@mail.mcgill.ca.
2
Division of Cardiology, McGill University, Montreal, Quebec, Canada.
3
Division of Cardiology, Duke University, Durham, NC, United States.
4
Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, United States.
5
Divisions of Cardiology and Pulmonary and Critical Care Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, United States.
6
Department of Critical Care and Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada.

Abstract

BACKGROUND:

Quality indicators (QIs) are increasingly used in cardiovascular care as measures of performance but there is currently no consensus on indicators for the cardiovascular intensive care unit (CICU).

METHODS:

We searched Medline, CINAHL, EMBASE, and COCHRANE databases from inception until October 2016 and websites for organizations involved in quality measurement for QIs relevant to cardiovascular disease in an intensive or critical care setting. We surveyed 14 expert cardiac intensivist-administrators (7 European; 7 North American) on the importance and relevance of each indicator as a measure of CICU care quality using a scale of 1 (=lowest) to 10 (=highest). Indicators with a mean score ≥8/10 for both importance and relevance were included in the final set.

RESULTS:

Overall, 108 QIs (70 process, 18 structural, 18 outcome, 1 patient engagement, and 1 covering multiple domains) were identified in 30 articles representing 23 agencies, organizations, and societies. Disease-specific QIs included myocardial infarction (n = 37), heart failure (n = 31), atrial fibrillation (n = 11), and cardiac rehabilitation (n = 1); general QIs represented about one-quarter (n = 28) of all measures. Fifteen QIs were selected for the final QI set: 7 process, 2 structural, and 6 outcome measures, including 6 general and 9 disease-specific measures. Outcome measures chosen to evaluate general CICU performance included overall CICU mortality, length of stay, and readmission rate.

CONCLUSIONS:

Numerous QIs relevant to the CICU have been recommended by a variety of organizations. The indicators chosen by the cardiac intensivist-administrators could serve as a basis for future efforts to develop a standardized set of quality measures for the CICU.

KEYWORDS:

Cardiovascular intensive care unit; Quality indicators; Quality of care; Review

PMID:
29514748
DOI:
10.1016/j.ijcard.2018.02.113
[Indexed for MEDLINE]

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