Effects of a national quality improvement program on ICUs in China: a controlled pre-post cohort study in 586 hospitals
Introduction Patient safety and critical care quality remain a challenging issue in the ICU. However, the effects of the national quality improvement (QI) program remain unknown in China. Methods A national ICU QI program was implemented in a controlled cohort of 586 hospitals from 2016 to 2018. The...
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| Veröffentlicht in: | Critical care (London, England) England), 2020-03, Vol.24 (1), p.73-73, Article 73 |
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| creator | He, Huaiwu Ma, Xudong Su, Longxiang Wang, Lu Guo, Yanhong Shan, Guangliang He, Hui Jing Zhou, Xiang Liu, Dawei Long, Yun Zhao, Yupei Zhang, Shuyang |
| description | Introduction Patient safety and critical care quality remain a challenging issue in the ICU. However, the effects of the national quality improvement (QI) program remain unknown in China. Methods A national ICU QI program was implemented in a controlled cohort of 586 hospitals from 2016 to 2018. The effects of the QI program on critical care quality were comprehensively investigated. Main results A total of 81,461,554 patients were enrolled in 586 hospitals, and 1,587,724 patients were admitted to the ICU over 3 years. In 2018, there was a significantly higher number of ICU beds (2016 vs. 2018: 10668 vs. 13,661, P = 0.0132) but a lower doctor-to-bed ratio (2016 vs. 2018: 0.64 (0.50, 0.83) vs. 0.60 (0.45, 0.75), P = 0.0016) and nurse-to-bed ratio (2016 vs. 2018: 2.00 (1.64, 2.50) vs. 2.00 (1.50, 2.40), P = 0.031) than in 2016. Continuous and significant improvements in the ventilator-associated pneumonia (VAP) incidence rate, microbiology detection rate before antibiotic use and deep vein thrombosis (DVT) prophylaxis rate were associated with the implementation of the QI program (VAP incidence rate (per 1000 ventilator-days), 2016 vs. 2017 vs. 2018: 11.06 (4.23, 22.70) vs. 10.20 (4.25, 23.94) vs. 8.05 (3.13, 17.37), P = 0.0002; microbiology detection rate before antibiotic use (%), 2016 vs. 2017 vs. 2018: 83.91 (49.75, 97.87) vs. 84.14 (60.46, 97.24) vs. 90.00 (69.62, 100), P < 0.0001; DVT prophylaxis rate, 2016 vs. 2017 vs. 2018: 74.19 (33.47, 96.16) vs. 71.70 (38.05, 96.28) vs. 83.27 (47.36, 97.77), P = 0.0093). Moreover, the 6-h SSC bundle compliance rates in 2018 were significantly higher than those in 2016 (6-h SSC bundle compliance rate, 2016 vs. 2018: 64.93 (33.55, 93.06) vs. 76.19 (46.88, 96.67)). A significant change trend was not found in the ICU mortality rate from 2016 to 2018 (ICU mortality rate (%), 2016 vs. 2017 vs. 2018: 8.49 (4.42, 14.82) vs. 8.95 (4.89, 15.70) vs. 9.05 (5.12, 15.80), P = 0.1075). Conclusions The relationship between medical human resources and ICU overexpansion was mismatched during the past 3 years. The implementation of a national QI program improved ICU performance but did not reduce ICU mortality. |
| doi_str_mv | 10.1186/s13054-020-2790-1 |
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However, the effects of the national quality improvement (QI) program remain unknown in China. Methods A national ICU QI program was implemented in a controlled cohort of 586 hospitals from 2016 to 2018. The effects of the QI program on critical care quality were comprehensively investigated. Main results A total of 81,461,554 patients were enrolled in 586 hospitals, and 1,587,724 patients were admitted to the ICU over 3 years. In 2018, there was a significantly higher number of ICU beds (2016 vs. 2018: 10668 vs. 13,661, P = 0.0132) but a lower doctor-to-bed ratio (2016 vs. 2018: 0.64 (0.50, 0.83) vs. 0.60 (0.45, 0.75), P = 0.0016) and nurse-to-bed ratio (2016 vs. 2018: 2.00 (1.64, 2.50) vs. 2.00 (1.50, 2.40), P = 0.031) than in 2016. Continuous and significant improvements in the ventilator-associated pneumonia (VAP) incidence rate, microbiology detection rate before antibiotic use and deep vein thrombosis (DVT) prophylaxis rate were associated with the implementation of the QI program (VAP incidence rate (per 1000 ventilator-days), 2016 vs. 2017 vs. 2018: 11.06 (4.23, 22.70) vs. 10.20 (4.25, 23.94) vs. 8.05 (3.13, 17.37), P = 0.0002; microbiology detection rate before antibiotic use (%), 2016 vs. 2017 vs. 2018: 83.91 (49.75, 97.87) vs. 84.14 (60.46, 97.24) vs. 90.00 (69.62, 100), P < 0.0001; DVT prophylaxis rate, 2016 vs. 2017 vs. 2018: 74.19 (33.47, 96.16) vs. 71.70 (38.05, 96.28) vs. 83.27 (47.36, 97.77), P = 0.0093). Moreover, the 6-h SSC bundle compliance rates in 2018 were significantly higher than those in 2016 (6-h SSC bundle compliance rate, 2016 vs. 2018: 64.93 (33.55, 93.06) vs. 76.19 (46.88, 96.67)). A significant change trend was not found in the ICU mortality rate from 2016 to 2018 (ICU mortality rate (%), 2016 vs. 2017 vs. 2018: 8.49 (4.42, 14.82) vs. 8.95 (4.89, 15.70) vs. 9.05 (5.12, 15.80), P = 0.1075). Conclusions The relationship between medical human resources and ICU overexpansion was mismatched during the past 3 years. The implementation of a national QI program improved ICU performance but did not reduce ICU mortality.</description><identifier>ISSN: 1364-8535</identifier><identifier>EISSN: 1466-609X</identifier><identifier>EISSN: 1364-8535</identifier><identifier>EISSN: 1366-609X</identifier><identifier>DOI: 10.1186/s13054-020-2790-1</identifier><identifier>PMID: 32131872</identifier><language>eng</language><publisher>LONDON: Springer Nature</publisher><subject>Antibiotics ; Catheters ; China ; Cohort analysis ; Critical care ; Critical Care Medicine ; Evaluation ; Evidence-based medicine ; General & Internal Medicine ; Health care reform ; Hospitals ; ICU ; Intensive care ; Intervention ; Life Sciences & Biomedicine ; Medical care quality ; Medical errors ; Medical quality ; Microbiology ; Mortality ; Nosocomial infections ; Nurses ; Patients ; Physicians ; Pneumonia ; Prophylaxis ; Provinces ; Quality control ; Quality improvement ; Quality improvement (QI) program ; Quality management ; Science & Technology ; Sepsis ; Thrombosis</subject><ispartof>Critical care (London, England), 2020-03, Vol.24 (1), p.73-73, Article 73</ispartof><rights>COPYRIGHT 2020 BioMed Central Ltd.</rights><rights>2020. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s). 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>15</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000521070200001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c560t-b8c2dd4f0316970f624203ac76251ae7cbb0a5346a68f3ceb05e6b17bae59ecb3</citedby><cites>FETCH-LOGICAL-c560t-b8c2dd4f0316970f624203ac76251ae7cbb0a5346a68f3ceb05e6b17bae59ecb3</cites><orcidid>0000-0002-0942-2870 ; 0000-0001-8523-8082</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7057512/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7057512/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,2103,2115,27929,27930,28253,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32131872$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>He, Huaiwu</creatorcontrib><creatorcontrib>Ma, Xudong</creatorcontrib><creatorcontrib>Su, Longxiang</creatorcontrib><creatorcontrib>Wang, Lu</creatorcontrib><creatorcontrib>Guo, Yanhong</creatorcontrib><creatorcontrib>Shan, Guangliang</creatorcontrib><creatorcontrib>He, Hui Jing</creatorcontrib><creatorcontrib>Zhou, Xiang</creatorcontrib><creatorcontrib>Liu, Dawei</creatorcontrib><creatorcontrib>Long, Yun</creatorcontrib><creatorcontrib>Zhao, Yupei</creatorcontrib><creatorcontrib>Zhang, Shuyang</creatorcontrib><creatorcontrib>Chian-NCCQC Grp</creatorcontrib><creatorcontrib>China-NCCQC group</creatorcontrib><creatorcontrib>China-NCCQC group</creatorcontrib><title>Effects of a national quality improvement program on ICUs in China: a controlled pre-post cohort study in 586 hospitals</title><title>Critical care (London, England)</title><addtitle>CRIT CARE</addtitle><addtitle>Crit Care</addtitle><description>Introduction Patient safety and critical care quality remain a challenging issue in the ICU. However, the effects of the national quality improvement (QI) program remain unknown in China. Methods A national ICU QI program was implemented in a controlled cohort of 586 hospitals from 2016 to 2018. The effects of the QI program on critical care quality were comprehensively investigated. Main results A total of 81,461,554 patients were enrolled in 586 hospitals, and 1,587,724 patients were admitted to the ICU over 3 years. In 2018, there was a significantly higher number of ICU beds (2016 vs. 2018: 10668 vs. 13,661, P = 0.0132) but a lower doctor-to-bed ratio (2016 vs. 2018: 0.64 (0.50, 0.83) vs. 0.60 (0.45, 0.75), P = 0.0016) and nurse-to-bed ratio (2016 vs. 2018: 2.00 (1.64, 2.50) vs. 2.00 (1.50, 2.40), P = 0.031) than in 2016. Continuous and significant improvements in the ventilator-associated pneumonia (VAP) incidence rate, microbiology detection rate before antibiotic use and deep vein thrombosis (DVT) prophylaxis rate were associated with the implementation of the QI program (VAP incidence rate (per 1000 ventilator-days), 2016 vs. 2017 vs. 2018: 11.06 (4.23, 22.70) vs. 10.20 (4.25, 23.94) vs. 8.05 (3.13, 17.37), P = 0.0002; microbiology detection rate before antibiotic use (%), 2016 vs. 2017 vs. 2018: 83.91 (49.75, 97.87) vs. 84.14 (60.46, 97.24) vs. 90.00 (69.62, 100), P < 0.0001; DVT prophylaxis rate, 2016 vs. 2017 vs. 2018: 74.19 (33.47, 96.16) vs. 71.70 (38.05, 96.28) vs. 83.27 (47.36, 97.77), P = 0.0093). Moreover, the 6-h SSC bundle compliance rates in 2018 were significantly higher than those in 2016 (6-h SSC bundle compliance rate, 2016 vs. 2018: 64.93 (33.55, 93.06) vs. 76.19 (46.88, 96.67)). A significant change trend was not found in the ICU mortality rate from 2016 to 2018 (ICU mortality rate (%), 2016 vs. 2017 vs. 2018: 8.49 (4.42, 14.82) vs. 8.95 (4.89, 15.70) vs. 9.05 (5.12, 15.80), P = 0.1075). Conclusions The relationship between medical human resources and ICU overexpansion was mismatched during the past 3 years. The implementation of a national QI program improved ICU performance but did not reduce ICU mortality.</description><subject>Antibiotics</subject><subject>Catheters</subject><subject>China</subject><subject>Cohort analysis</subject><subject>Critical care</subject><subject>Critical Care Medicine</subject><subject>Evaluation</subject><subject>Evidence-based medicine</subject><subject>General & Internal Medicine</subject><subject>Health care reform</subject><subject>Hospitals</subject><subject>ICU</subject><subject>Intensive care</subject><subject>Intervention</subject><subject>Life Sciences & Biomedicine</subject><subject>Medical care quality</subject><subject>Medical errors</subject><subject>Medical quality</subject><subject>Microbiology</subject><subject>Mortality</subject><subject>Nosocomial infections</subject><subject>Nurses</subject><subject>Patients</subject><subject>Physicians</subject><subject>Pneumonia</subject><subject>Prophylaxis</subject><subject>Provinces</subject><subject>Quality control</subject><subject>Quality improvement</subject><subject>Quality improvement (QI) program</subject><subject>Quality management</subject><subject>Science & Technology</subject><subject>Sepsis</subject><subject>Thrombosis</subject><issn>1364-8535</issn><issn>1466-609X</issn><issn>1364-8535</issn><issn>1366-609X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AOWDO</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>DOA</sourceid><recordid>eNqNkk9vFCEYxidGY2v1A3gxJF5MzFT-DDDjoUkzqbpJEy828UaAgV02M7AFpk2_vUy3blzjQThAXn7PQ-B9quotgucItexTQgTSpoYY1ph3sEbPqlPUMFYz2P18XvaENXVLCT2pXqW0hRDxlpGX1QnBiKCW49Pq_spao3MCwQIJvMwueDmC21mOLj8AN-1iuDOT8RmU3TrKCQQPVv1NAs6DfuO8_FyEOvgcwziaoWCm3oWUS20TYgYpz8PDAtOWgU1IO5flmF5XL2xZzJun9ay6-XL1o_9WX3__uuovr2tNGcy1ajUehsZCgljHoWW4wZBIzRmmSBqulYKSkoZJ1lqijYLUMIW4koZ2RityVq32vkOQW7GLbpLxQQTpxGMhxLWQMTs9GsG4hS3Ug2JIN1gixa2WHcKdVVo1TBevi73XblaTGXT5lCjHI9PjE-82Yh3uBIeUU4SLwYcngxhuZ5OymFzSZhylN2FOAhOOWkq7Bhb0_V_oNsyxtOaRahnCuDT2QK1leYDzNpR79WIqLhlihDQdJIU6_wdV5mAmVzpnrCv1IwHaC3QMKUVjD29EUCzJE_vkiZI8sSRPoKJ59-fnHBS_o1aAj3vg3qhgk3bGa3PAIIQUI8iLYxmLXfv_dF8itQS3D7PP5BdF3fQ0</recordid><startdate>20200304</startdate><enddate>20200304</enddate><creator>He, Huaiwu</creator><creator>Ma, Xudong</creator><creator>Su, Longxiang</creator><creator>Wang, Lu</creator><creator>Guo, Yanhong</creator><creator>Shan, Guangliang</creator><creator>He, Hui Jing</creator><creator>Zhou, Xiang</creator><creator>Liu, Dawei</creator><creator>Long, Yun</creator><creator>Zhao, Yupei</creator><creator>Zhang, Shuyang</creator><general>Springer Nature</general><general>BioMed Central Ltd</general><general>BioMed Central</general><general>BMC</general><scope>AOWDO</scope><scope>BLEPL</scope><scope>DTL</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-0942-2870</orcidid><orcidid>https://orcid.org/0000-0001-8523-8082</orcidid></search><sort><creationdate>20200304</creationdate><title>Effects of a national quality improvement program on ICUs in China: a controlled pre-post cohort study in 586 hospitals</title><author>He, Huaiwu ; Ma, Xudong ; Su, Longxiang ; Wang, Lu ; Guo, Yanhong ; Shan, Guangliang ; He, Hui Jing ; Zhou, Xiang ; Liu, Dawei ; Long, Yun ; Zhao, Yupei ; Zhang, Shuyang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c560t-b8c2dd4f0316970f624203ac76251ae7cbb0a5346a68f3ceb05e6b17bae59ecb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Antibiotics</topic><topic>Catheters</topic><topic>China</topic><topic>Cohort analysis</topic><topic>Critical care</topic><topic>Critical Care Medicine</topic><topic>Evaluation</topic><topic>Evidence-based medicine</topic><topic>General & Internal Medicine</topic><topic>Health care reform</topic><topic>Hospitals</topic><topic>ICU</topic><topic>Intensive care</topic><topic>Intervention</topic><topic>Life Sciences & Biomedicine</topic><topic>Medical care quality</topic><topic>Medical errors</topic><topic>Medical quality</topic><topic>Microbiology</topic><topic>Mortality</topic><topic>Nosocomial infections</topic><topic>Nurses</topic><topic>Patients</topic><topic>Physicians</topic><topic>Pneumonia</topic><topic>Prophylaxis</topic><topic>Provinces</topic><topic>Quality control</topic><topic>Quality improvement</topic><topic>Quality improvement (QI) program</topic><topic>Quality management</topic><topic>Science & Technology</topic><topic>Sepsis</topic><topic>Thrombosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>He, Huaiwu</creatorcontrib><creatorcontrib>Ma, Xudong</creatorcontrib><creatorcontrib>Su, Longxiang</creatorcontrib><creatorcontrib>Wang, Lu</creatorcontrib><creatorcontrib>Guo, Yanhong</creatorcontrib><creatorcontrib>Shan, Guangliang</creatorcontrib><creatorcontrib>He, Hui Jing</creatorcontrib><creatorcontrib>Zhou, Xiang</creatorcontrib><creatorcontrib>Liu, Dawei</creatorcontrib><creatorcontrib>Long, Yun</creatorcontrib><creatorcontrib>Zhao, Yupei</creatorcontrib><creatorcontrib>Zhang, Shuyang</creatorcontrib><creatorcontrib>Chian-NCCQC Grp</creatorcontrib><creatorcontrib>China-NCCQC group</creatorcontrib><creatorcontrib>China-NCCQC group</creatorcontrib><collection>Web of Science - Science Citation Index Expanded - 2020</collection><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Proquest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Critical care (London, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>He, Huaiwu</au><au>Ma, Xudong</au><au>Su, Longxiang</au><au>Wang, Lu</au><au>Guo, Yanhong</au><au>Shan, Guangliang</au><au>He, Hui Jing</au><au>Zhou, Xiang</au><au>Liu, Dawei</au><au>Long, Yun</au><au>Zhao, Yupei</au><au>Zhang, Shuyang</au><aucorp>Chian-NCCQC Grp</aucorp><aucorp>China-NCCQC group</aucorp><aucorp>China-NCCQC group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of a national quality improvement program on ICUs in China: a controlled pre-post cohort study in 586 hospitals</atitle><jtitle>Critical care (London, England)</jtitle><stitle>CRIT CARE</stitle><addtitle>Crit Care</addtitle><date>2020-03-04</date><risdate>2020</risdate><volume>24</volume><issue>1</issue><spage>73</spage><epage>73</epage><pages>73-73</pages><artnum>73</artnum><issn>1364-8535</issn><eissn>1466-609X</eissn><eissn>1364-8535</eissn><eissn>1366-609X</eissn><abstract>Introduction Patient safety and critical care quality remain a challenging issue in the ICU. However, the effects of the national quality improvement (QI) program remain unknown in China. Methods A national ICU QI program was implemented in a controlled cohort of 586 hospitals from 2016 to 2018. The effects of the QI program on critical care quality were comprehensively investigated. Main results A total of 81,461,554 patients were enrolled in 586 hospitals, and 1,587,724 patients were admitted to the ICU over 3 years. In 2018, there was a significantly higher number of ICU beds (2016 vs. 2018: 10668 vs. 13,661, P = 0.0132) but a lower doctor-to-bed ratio (2016 vs. 2018: 0.64 (0.50, 0.83) vs. 0.60 (0.45, 0.75), P = 0.0016) and nurse-to-bed ratio (2016 vs. 2018: 2.00 (1.64, 2.50) vs. 2.00 (1.50, 2.40), P = 0.031) than in 2016. Continuous and significant improvements in the ventilator-associated pneumonia (VAP) incidence rate, microbiology detection rate before antibiotic use and deep vein thrombosis (DVT) prophylaxis rate were associated with the implementation of the QI program (VAP incidence rate (per 1000 ventilator-days), 2016 vs. 2017 vs. 2018: 11.06 (4.23, 22.70) vs. 10.20 (4.25, 23.94) vs. 8.05 (3.13, 17.37), P = 0.0002; microbiology detection rate before antibiotic use (%), 2016 vs. 2017 vs. 2018: 83.91 (49.75, 97.87) vs. 84.14 (60.46, 97.24) vs. 90.00 (69.62, 100), P < 0.0001; DVT prophylaxis rate, 2016 vs. 2017 vs. 2018: 74.19 (33.47, 96.16) vs. 71.70 (38.05, 96.28) vs. 83.27 (47.36, 97.77), P = 0.0093). Moreover, the 6-h SSC bundle compliance rates in 2018 were significantly higher than those in 2016 (6-h SSC bundle compliance rate, 2016 vs. 2018: 64.93 (33.55, 93.06) vs. 76.19 (46.88, 96.67)). A significant change trend was not found in the ICU mortality rate from 2016 to 2018 (ICU mortality rate (%), 2016 vs. 2017 vs. 2018: 8.49 (4.42, 14.82) vs. 8.95 (4.89, 15.70) vs. 9.05 (5.12, 15.80), P = 0.1075). Conclusions The relationship between medical human resources and ICU overexpansion was mismatched during the past 3 years. The implementation of a national QI program improved ICU performance but did not reduce ICU mortality.</abstract><cop>LONDON</cop><pub>Springer Nature</pub><pmid>32131872</pmid><doi>10.1186/s13054-020-2790-1</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0002-0942-2870</orcidid><orcidid>https://orcid.org/0000-0001-8523-8082</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1364-8535 |
| ispartof | Critical care (London, England), 2020-03, Vol.24 (1), p.73-73, Article 73 |
| issn | 1364-8535 1466-609X 1364-8535 1366-609X |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7057512 |
| source | DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; SpringerNature Journals; Springer Nature OA Free Journals; Web of Science - Science Citation Index Expanded - 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" />; PubMed Central; Alma/SFX Local Collection |
| subjects | Antibiotics Catheters China Cohort analysis Critical care Critical Care Medicine Evaluation Evidence-based medicine General & Internal Medicine Health care reform Hospitals ICU Intensive care Intervention Life Sciences & Biomedicine Medical care quality Medical errors Medical quality Microbiology Mortality Nosocomial infections Nurses Patients Physicians Pneumonia Prophylaxis Provinces Quality control Quality improvement Quality improvement (QI) program Quality management Science & Technology Sepsis Thrombosis |
| title | Effects of a national quality improvement program on ICUs in China: a controlled pre-post cohort study in 586 hospitals |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-12T15%3A37%3A16IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Effects%20of%20a%20national%20quality%20improvement%20program%20on%20ICUs%20in%20China:%20a%20controlled%20pre-post%20cohort%20study%20in%20586%20hospitals&rft.jtitle=Critical%20care%20(London,%20England)&rft.au=He,%20Huaiwu&rft.aucorp=Chian-NCCQC%20Grp&rft.date=2020-03-04&rft.volume=24&rft.issue=1&rft.spage=73&rft.epage=73&rft.pages=73-73&rft.artnum=73&rft.issn=1364-8535&rft.eissn=1466-609X&rft_id=info:doi/10.1186/s13054-020-2790-1&rft_dat=%3Cgale_pubme%3EA616334903%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2378612285&rft_id=info:pmid/32131872&rft_galeid=A616334903&rft_doaj_id=oai_doaj_org_article_67f080cdb61c42a1b7fca9129fbcb46c&rfr_iscdi=true |