Reducing administrative burden by implementing a core set of quality indicators in the ICU: a multicentre longitudinal intervention study.

Autor:	Hesselink G; Intensive Care, Radboud University Medical Center, Nijmegen, The Netherlands Gijs.Hesselink@radboudumc.nl., Verhage R; Intensive Care, Radboud University Medical Center, Nijmegen, The Netherlands., Westerhof B; Intensive Care, Rijnstate Hospital, Arnhem, The Netherlands., Verweij E; Intensive Care, Bernhoven Hospital, Uden, The Netherlands., Fuchs M; Intensive Care, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands., Janssen I; Intensive Care, Maas Hospital Pantein, Boxmeer, The Netherlands., van der Meer C; Intensive Care, Rivierenland Hospital, Tiel, The Netherlands., van der Horst ICC; Intensive Care, Maastricht University Medical Center+, Maastricht, The Netherlands.; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands., de Jong P; Intensive Care, Slingeland Hospital, Doetinchem, The Netherlands., van der Hoeven JG; Intensive Care, Radboud University Medical Center, Nijmegen, The Netherlands., Zegers M; Intensive Care, Radboud University Medical Center, Nijmegen, The Netherlands.
Jazyk:	angličtina
Zdroj:	BMJ quality & safety [BMJ Qual Saf] 2024 Aug 30. Date of Electronic Publication: 2024 Aug 30.
DOI:	10.1136/bmjqs-2024-017481
Abstrakt:	Background: The number of quality indicators for which clinicians need to record data is increasing. For many indicators, there are concerns about their efficacy. This study aimed to determine whether working with only a consensus-based core set of quality indicators in the intensive care unit (ICU) reduces the time spent on documenting performance data and administrative burden of ICU professionals, and if this is associated with more joy in work without impacting the quality of ICU care. Methods: Between May 2021 and June 2023, ICU clinicians of seven hospitals in the Netherlands were instructed to only document data for a core set of quality indicators. Time spent on documentation, administrative burden and joy in work were collected at three time points with validated questionnaires. Longitudinal data on standardised mortality rates (SMR) and ICU readmission rates were gathered from the Dutch National Intensive Care registry. Longitudinal effects and differences in outcomes between ICUs and between nurses and physicians were statistically tested. Results: A total of 390 (60%), 291 (47%) and 236 (40%) questionnaires returned at T0, T1 and T2. At T2, the overall median time spent on documentation per day was halved by 30 min (p<0.01) and respondents reported fewer unnecessary and unreasonable administrative tasks (p<0.01). Almost one-third still experienced unnecessary administrative tasks. No significant changes over time were found in joy in work, SMR and ICU readmission. Conclusions: Implementing a core set of quality indicators reduces the time ICU clinicians spend on documentation and administrative burden without negatively affecting SMR or ICU readmission rates. Time savings can be invested in patient care and improving joy in work in the ICU. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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