Voluntary peer review as innovative tool for quality improvement in the intensive care unit – a retrospective descriptive cohort study in German intensive care units

GMS German Medical Science

,¹  Spies, Claudia²  Kumpf, Oliver²  Deja, Maria²  Braun, Jan-Peter³  Bloos, Frank⁴  Greim, Clemens-A.⁵  Brinkmann, Alexander⁶  Weiler, Norbert⁷  Marx, Gernot⁸  Muhl, Elke⁹  Chop, Ines^1,10  Jonitz, Günther^1,10  Dubb, Rolf^1,11  Kaltwasser, Arnold^1,11  Bause, Hanswerner^1,12  Felsenstein, Matthias^1,13  Schaefer, Henning^1,14  Jungbluth, Annemarie^1,15  Leffmann, Carsten^1,16  Liebeskind, Ursula^1,17  Pronovost, Peter^1,18  Waydhas, Christian^1,19 

[1] ;Department of Anaesthesiology and Intensive Care Medicine, Campus Charité Mitte and Campus Virchow-Klinikum, Charité – Universitätsmedizin Berlin, Berlin, Germany;Department of Anaesthesiology and Intensive Care Medicine, Helios Klinikum Hildesheim, Hildesheim, Germany;Department of Anaesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany;Department of Anaesthesiology and Intensive Care Medicine, Klinikum Fulda, Fulda, Germany;Department of Anaesthesiology and Intensive Care Medicine, Klinikum Heidenheim, Heidenheim, Germany;Department of Anaesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany;Department of Intensive Care Medicine, Universitätsklinikum RWTH Aachen, Aachen, Germany;Department of Surgery, University Medical Centre Schleswig-Holstein, Campus Luebeck, Luebeck, Germany;German Medical Association, Berlin, Germany;Kreiskliniken Reutlingen GmbH, Reutlingen, Germany;Quality Committee of the State Chamber of Physicians, Hamburg, Germany;State Chamber of Physicians Baden-Württemberg, Stuttgart, Germany;State Chamber of Physicians Berlin, Berlin, Germany;State Chamber of Physicians Hamburg, Hamburg, Germany;State Chamber of Physicians Schleswig-Holstein, Bad Segeberg, Germany;State Chamber of Physicians Thüringen, Jena, Germany;The Johns Hopkins University School of Medicine, Departments of Anesthesiology/Critical Care Medicine and Surgery, Baltimore, Maryland, United States;Trauma Surgery Department, University Hospital Essen, Germany;

关键词: peer review;    critical care;    patient safety;    quality improvement;    quality management;   

DOI  :  10.3205/000202

来源: DOAJ

【 摘 要 】

[english] Introduction: Quality improvement and safety in intensive care are rapidly evolving topics. However, there is no gold standard for assessing quality improvement in intensive care medicine yet. In 2007 a pilot project in German intensive care units (ICUs) started using voluntary peer reviews as an innovative tool for quality assessment and improvement. We describe the method of voluntary peer review and assessed its feasibility by evaluating anonymized peer review reports and analysed the thematic clusters highlighted in these reports.Methods: Retrospective data analysis from 22 anonymous reports of peer reviews. All ICUs – representing over 300 patient beds – had undergone voluntary peer review. Data were retrieved from reports of peers of the review teams and representatives of visited ICUs. Data were analysed with regard to number of topics addressed and results of assessment questionnaires. Reports of strengths, weaknesses, opportunities and threats (SWOT reports) of these ICUs are presented. Results: External assessment of structure, process and outcome indicators revealed high percentages of adherence to predefined quality goals. In the SWOT reports 11 main thematic clusters were identified representative for common ICUs. 58.1% of mentioned topics covered personnel issues, team and communication issues as well as organisation and treatment standards. The most mentioned weaknesses were observed in the issues documentation/reporting, hygiene and ethics. We identified several unique patterns regarding quality in the ICU of which long-term personnel problems und lack of good reporting methods were most interestingConclusion: Voluntary peer review could be established as a feasible and valuable tool for quality improvement. Peer reports addressed common areas of interest in intensive care medicine in more detail compared to other methods like measurement of quality indicators.

【 授权许可】

Unknown