Quality of care (IT systems)
Quality of care. Within this research line, we are working on improving healthcare and preventing errors. This is achieved by developing quality indicators, case mix correction, comparing various hospitals, and providing feedback to healthcare providers. This feedback allows to enhance their behavior and/or care processes. We aim to reuse routinely collected data and investigate how changes in computer programs or in data recording may contribute to healthcare improvement. We primarily focus on the intensive care, but we also have projects in other specialties and in healthcare systems of low- and middle income countries, for example in Asia and Africa.
For health outcomes, socioeconomic status (SES) is an important determinant. Generally, a lower SES is associated with more adverse healthcare outcomes. It is unclear whether this phenomenon is present in patients admitted to the intensive care unit (ICU), especially in The Netherlands. Therefore, this nationwide observational cohort study will investigate SES in the total Dutch ICU population and across regions, the association between SES and (hospital/long-term) mortality, and its effect on individual estimated mortality risks. Depending on the outcomes, we will try to improve the case-mix model (APACHE IV) for estimating individual mortality risks and examine its influence on benchmarking Dutch ICUs. We will use a composited (occupation, income, education) SES score per household and per postal code to identify possible differences between these scores.
Research line: Evaluation of Healthcare and Health IT Systems
In the ICU, 71% of the patients receive antibiotics. Of these antibiotics, 30% to 60% is prescribed unnecessary, inappropriate, or suboptimal.
Audit & Feedback is proven to be effective in stimulating quality improvement, therefore the NICE2Improve dashboard was developed. This dashboard includes actionable quality indicators and a toolbox with suggestions of improvement actions to support ICU staff on how they can increase appropriate antibiotics use. The purpose of this research is to pinpoint areas where specific ICUs might experience barriers to quality improvement, to devise a method for creating a tailored toolbox, and to evaluate the effectiveness of the tailored toolbox in enhancing antibiotic use in the ICU.
Prof. dr. Nicolette de Keizer, dr. Ferishta Raiez, dr. Marie-José Blom, dr. Sylvia Brinkman, dr. Fabian Termorshuizen, Juliette Pape-Boesenkool MSc, Safira Wortel MSc, Daniëlle Koornneef MSc, Daphne Stegink MSc, Thomas van Egmond MSc, Eric van der Zwan MSc, Winston Tjon Sjoe Sjoe MSc, Carlos Piães Morais, Georgette van Velzen