Intensive care performance: how should we monitor performance in the future?

Abstract

Abstract Intensive care faces economic challenges. Therefore evidence proving both effectiveness and efficiency, i.e. cost-effectiveness, of delivered care is needed. Today, the quality of care is an important issue in the health care debate. How do we measure quality of care, and how accurate and representative is this measurement? In the following report several topics, which are used for the evaluation of ICU performance, are discussed: (1) The use of general outcome prediction models to assess/ quantify the risk of patients who are admitted to our ICUs in an increasing variety in case mix for all the different intensive care units. Together with three major limitation; (2) As critical care outcomes research becomes a more established entity mortality is now only one of many endpoints that are of relevance. Mortality is a limited outcome when assessing critical care performance, while patient interest in QoL outcomes is of relevance; and (3) The Quality Indicators Committee of the Society of Critical Care Medicine recommended that short-term readmission is a leading performance indicator of the quality of intensive care medicine