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Highlights Dr Brian Cook

Highlights Dr Brian Cook. Scottish Critical Care Activity 2009. SICSAG: Why?. “We exist to improve the quality of care delivered to critical care patients by monitoring and comparing activities and outcomes across Scottish Critical Care. We intend to drive standards and quality of care

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Highlights Dr Brian Cook

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  1. Highlights Dr Brian Cook

  2. Scottish Critical Care Activity 2009

  3. SICSAG: Why? “We exist to improve the quality of care delivered to critical care patients by monitoring and comparing activities and outcomes across Scottish Critical Care. We intend to drive standards and quality of care upward by engagement with clinical staff, and to provide them with information that can be used in quality improvement programmes.”

  4. Quality of Care: Quality Indicators? • Structure: • Numbers/Occupancy • Staffing levels (Cons, Nursing, Others) • Quality Improvement Programmes • Infection Control Strategies • Process: • Out of Hours Discharges/Admissions • Early Discharges • Delayed Discharges • Readmissions • Outcome • Mortality: SMR • HAI’s (Not comparative between units)

  5. SMR by Various Means

  6. CUSUM Early Warning- Monthly Reports

  7. Response to SMR > 2SD from Mean • Letter to unit lead and managers May (17/5/10) • Suggested courses of action • Case mix unusual? • Data accurate and complete? • Selected case note reviews? • Discuss with referring specialties? • Supporting evidence- local and other audits? • External review? • Further analysis by SICSAG • Report from unit to SICSAG by July (20/7/10) • SICSAG report published with original data July (27/7/10)

  8. SMR Through Time

  9. Out of Hours Admissions and Discharges

  10. “Bed blocking epidemic in Scottish intensive care units” 28th July 2010

  11. Delayed Discharges

  12. Early Discharges, Readmissions and Capacity

  13. Quality of Care: The Future • SICSAG funded in current form (ISD/NHS QIS) • Quality Indicators NHS QIS/NHS Scotland • Structure • Process • Outcomes • SPSP measures • HAI surveillance HPS

  14. Thank You

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