Quality & Safety Research
Introduction
One of ICCMU's main aims is to work with clinicians and key organisations to identify, address, and improve quality and safety issues in NSW ICUs. These webpages will highlight some of the current quality and safety (Q&S) issues that have been identified and are being addressed via various projects. There is a section dedicated to infection control, a highly important issue for intensive care practice. Other useful content includes a Resource Library for access to tools and practical information about various Q&S projects and Weblinks to sites containing related or further information of interest.
ICCMU's role in Quality & Safety Research is reflected in two of its three main objectives:
- Promoting excellence in the standard of care in all NSW ICUs by providing a forum for the systematic analysis and assessment of information regarding the quality of care in NSW intensive care units (see ICCMU Quality Group below).
- Facilitating an understanding of Intensive Care service provision including resources, workforce, patterns of demand including access issues, and other factors that may impact on the effective delivery of intensive care service in NSW through the Data Management Committee.
ICCMU works collaboratively with a number of organisations and key groups in NSW and Australia to achieve these goals including:
- NSW Clinical Excellence Commission
- UTS Faculty of Nursing, Midwifery & Health
- ANZICS Centre for Outcome and Resource Evaluation (CORE)
- ANZICS Safety & Quality Committee
- ANZICS Clinical Trials Group
- George Institute for International Health
- Aero-medical Retrieval Service (AMRS)
- Australian College of Critical Care Nurses (ACCCN)
ICCMU Quality Group
The ICCMU Quality Group (ICCMUQG) provides a forum for the systematic analysis, assessment and dissemination of information regarding the quality of care (Objective C) in NSW intensive care units: in particular, incident monitoring, clinical indicators and clinical audits. ICCMUQG uses a multi-modal approach to reviewing quality in NSW ICUs. Work continues on collating, reviewing and reporting relevant information from databases, such as the ANZICS Adult Patient Database (APD), and Medical Retrieval data. ICCMUQG also holds meetings with relevant members of the Clinical Excellence Commission, ANZICS Safety & Quality Committee and Quality and Safety Branch, NSW Health, amongst others.
Minutes of Quality Group meetings
Projects Overview
Quality & Safety projects undertaken by ICCMU include:
Exploring data collection processes and data quality in NSW ICUs
The results of the first survey were presented in a poster at the 5th Australasian Conference on Safety and Quality in Health Care, Melbourne (2007) and as an oral presentation at the 1st International Conference on Safety, Quality, Audit & Outcomes Research in Intensive Care, Queenstown, NZ (2007). A paper detailing the results of the first survey was published in Critical Care & Resuscitation (December 2008- see reference below). A follow-up survey to ICU directors has commenced.
- Hewson-Conroy KM, Burrell AR. Preliminary insights into data collection processes in New South Wales intensive care units. Crit Care Resusc 2008; 10: 301-305.
- Hewson-Conroy KM, Burrell AR. (2007) Preliminary insights into data collection processes Australasian Quality & Safety Conference [poster]
- Hewson-Conroy KM, Burrell AR. (2007) Preliminary insights into data collection processes in New South Wales intensive care units. Ist International Conference on Safety, Quality, Audit & Outcomes in Intensive Care, Queenstown, New Zealand, 8-10 August 2007 [Oral presentation]
This ongoing project involves the development, implementation and evaluation of a "process of care" checklist, designed to assist ICU clinicians with the delivery of daily care to their patients. A paper-based checklist pilot has been completed and the results were presented as an oral presentation at the 1st Critical Care Conference in the Vineyards, Hunter Valley (2006), a poster presentation at the 4th Australasian Conference on Safety and Quality in Health Care, Melbourne (2006) and published in Anaesthesia and Intensive Care (June 2006- see reference below). The next phase of the research is a pilot of an electronic checklist in a tertiary ICU. Initial validation studies have been completed via a medical record audit and a modified-Delphi technique. Following the pilot, a multi-site trial evaluating a process of care methodology, that incorporates the checklist, is planned.Process of care in NSW ICUs.
- Hewson KM, Burrell AR. A pilot study to test the use of a checklist in a tertiary intensive care unit as a method of ensuring quality processes of care. Anaesth Intensive Care 2006; 34:322-328.
- Hewson KM, Burrell AR. (2006) A pilot study to test the use of a checklist in a tertiary intensive care unit as a method of ensuring quality processes of care.Australasian Quality & Safety Conference
- Hewson KM, Burrell AR. A pilot study to test the use of a checklist in a tertiary intensive care unit as a method of ensuring quality processes of care.Critical Care in the Vineyards
- Hewson KM, Elliott D & Burrell AR Improving process of care in NSW ICUs through collaboration & innovation. UTS Health Research Showcase, 19-20 November 2008 [oral presentation]
- Hewson KM & Burrell AR (2008)CTG Point prevalence study: process of care in ICU, 2nd International Conference on Safety, Quality, Audit & Outcomes Research in Intensive Care, Queenstown [oral presentation]
ICU Safety Culture
A pilot of the implementation of the Safety Attitudes Questionnaire (SAQ) to assess the perceived culture of safety in a tertiary ICU was completed and results were presented to the ICU and at the 1st International Conference on Safety, Quality, Audit & Outcomes Research in Intensive Care, Queenstown, NZ (2007). This has led to a joint ACCCN and ANZICS Safety & Quality Committee project currently underway.
- Owner of copyright to the Safety Attitudes Questionnaire (SAQ) and Safety Climate Survey (SCS). Contains survey tools, tracking forms, user guides, instructions and technical report.
Aeromedical Retrieval Service
AMRS data is presented in monthly reports to the ICT, quarterly reports to the CCHPT, and adhoc reports to key stakeholders including the Surgical Services Taskforce. ICCMU also responds to various information requests that arise with regards to interhospital transfers e.g. for AHS service planning and ministerials.
Access to AMRS reports (ICT members only)
ICU indicators
The ICCMUQG advised the ANZICS Safety & Quality Committee on the indicators to be put to the ACHS for ICU indicators in 2007. ICU data items are being developed by ICCMU in conjunction with the Data Management Committee for inclusion in a minimum dataset for reporting by ICU Data Managers. Currently investigating the utility of scorecards and radar plots in conjunction with ANZICS.
If there is something you think is relevant and appropriate please contact ICCMU.
