Feedback and perspectives

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November 24

th

2004

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MEMBERS

D. Biarent, L. Bossaert, P. Damas, R. De Jongh,

L. Huyghens, E. Installé, T. Sottiaux, K. Vandewoude

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FEEDBACK

• WEBSITE

• ICU-LANDSCAPE

• COMMUNICATION – EDUCATION • NON-INVASIVE VENTILATION

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PROSPECTIVES

• NOSOCOMIAL INFECTIONS (WIV) • SAPI – BALANCED SCORE CARD • DATA MANAGER

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IC College Working Group : ICU landscape in Belgium

Ad hoc - L. Huyghens - L. Bossaert

J.P. Alexander

P. Damas

P. Ferdinande

P. Reper

IT support R. Tielemans (Uniweb)

SIZ Quality Improvement Group (Chair E. Installé)

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Methodology

• Identification of all ICU directors in Belgium

• Creation of website (www.iccollege.be)  questionnaire  individual password

• Data collection june 1st, 2002  july 31st, 2003

• Absolute commitment for strict confidentiality • Data cleaning (JPA & PF)

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Report

Response rate : 58 of 107 ICU directors (= 54 %) 988 ICU beds 1. General information 2. Staffing 3. Architecture 4. Bedside monitoring 5. Communication systems 6. Fire safety 7. Central services

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Parameters of activity

Number of admissions / ICU / year

2000 1151,8 ± 881,5 (791/306-3993)

2001 1136,9 ± 850,6 (839/384-3767)

2002 1094,47 ± 870,6 (792/303-3995)

Number of admissions / ICU bed / year

2000 75,8 ± 24,2 (70,8/43,7-145,2)

2001 74,9 ± 22,2 (71,6/44,3-140,7)

2002 74,7 ± 24,2 (70,4/33,7-134,2)

ICU LOS days

2000 4,16 ± 1,0 (4,2/1,92-6,5) 2001 4,17 ± 1,1 (4,0/1,89-7,9) 2002 4,32 ± 1,2 (4,2/2,15-8,2) Occupancy rate % 2000 83,3 ± 8,1 (82,4/65-100) 2001 82,9 ± 8,2 (83/67-98) 2002 82,9 ± 10,6 (83/58-100)

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Parameters of activity

Year Readmissions % ICU mortality %

2000 5,3 ± 3,3 (4,65/1-14) 8,6 ± 4,3 (8,0/0-21) 2001 4,8 ± 3,6 (3,8/1-15) 8,9 ± 4,1 (8,1/3,9-23) 2002 5,0 ± 3,5 (4,55/0,7-15) 9,2 ± 4,2 (9/3,5-23)

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Conclusions

• Intensive Care Medicine in Belgium is a

heterogeneous activity (staff and admitted patients)

• Both medical and nursing staffing are at the lower edge of the international standards

• Quality analysis of ICU processes can be done in the perspective of the case mix and outcome

parameters, but administrative support for the intensivist in the field is highly desirable