Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway.
Acta Anaesthesiol Scand. 2012 Oct;56(9):1078-83. doi: 10.1111/j.1399-6576.2012.02656.x. Epub 2012 Feb 16.
Quality indicators (QIs) are increasingly used in medicine in order to compare and eventually to improve quality of delivered health care. During the last decade, QIs also have been used within intensive care medicine. This paper shortly describes this development and gives an overview of QIs in the intensive care unit (ICU) reported to be in use at national level. Using a search on PubMed and through World Wide Web, QIs documented to be in use at a national level were retrieved. The various sets of QI were compared, and the method to select QIs was found. The search retrieved national indicators from eight countries (United Kingdom, the Netherlands, Spain, Sweden, Germany, Scotland, Austria and India). A total of 63 QIs were in use, and no single indicator was common for all countries. The most frequently used indicator was the standardised mortality rate (in six of eight countries). Measurements of patient/family satisfaction, the presence of an ICU specialist 24/7 and the occurrence of ventilator-associated pneumonia were all used by five countries. All primarily used a physician-driven process to select national QIs. This survey reveals that the concept of QIs is perceived differently throughout countries, also within developed countries in Western Europe. At present, it will be difficult to use national QIs to compare the quality of intensive care between countries.
质量指标（QIs）在医学领域的应用日益广泛，旨在比较并最终提高所提供的医疗保健质量。在过去的十年中，质量指标也在重症监护医学中得到了应用。本文简要描述了这一发展，并概述了在重症监护病房（ICU）中使用的、据报道可在国家层面使用的质量指标。通过在 PubMed 上进行搜索和在万维网上查询，检索到了在国家层面使用的质量指标文档。对各种质量指标集进行了比较，并找到了选择质量指标的方法。检索结果显示，有八个国家（英国、荷兰、西班牙、瑞典、德国、苏格兰、奥地利和印度）都制定了国家指标。共有 63 个质量指标在使用，没有一个指标为所有国家所共有。使用最频繁的指标是标准化死亡率（在八个国家中的六个国家中使用）。有五个国家使用了衡量患者/家属满意度、24/7 存在 ICU 专科医生以及呼吸机相关性肺炎发生率的指标。所有国家都主要使用医生驱动的流程来选择国家质量指标。本调查显示，质量指标的概念在不同国家之间存在差异，即使在西欧的发达国家也是如此。目前，使用国家质量指标来比较各国之间的重症监护质量将非常困难。
