Article Text
PDF
Abstract
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.
- Continuous quality improvement
- Critical care
- Healthcare quality improvement
- Performance measures
- Quality measurement
Data availability statement
Data are available upon reasonable request. The datasets of the current study are available from the corresponding author upon reasonable request.
Statistics from Altmetric.com
- Continuous quality improvement
- Critical care
- Healthcare quality improvement
- Performance measures
- Quality measurement
Data availability statement
Data are available upon reasonable request. The datasets of the current study are available from the corresponding author upon reasonable request.
Footnotes
Contributors MZ and HH conceived the study. GH, MZ and RV were responsible for the recruitment of participants and the collection of data. GH analysed and interpreted the data under the supervision of MZ. All other authors contributed substantially to the interpretation of data. GH drafted the manuscript, which was critically revised for important intellectual content by all other authors. All authors read and approved the final manuscript. GH is the guarantor for this manuscript. The corresponding author, GH, attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.
Funding This study was funded by Nederlandse Federatie van Universitair Medische Centra.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer-reviewed.
Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.