Continuous quality improvement in intensive care medicine. The GiViTI Margherita project - Report 2005

S. Boffelli, C. Rossi, A. Anghileri, M. Giardino, L. Carnevale, M. Messina, M. Neri, M. Langer, G. Bertolini, Marco Abastanotti, Arnaldo Alberti, Armando Alborghetti, Patrizia Angiolini, Borza Stefania Anticoli, Davide Archi, Enrico Arditi, Flavio Badii, Andrea Balata, Massimo Barattini, Remo BarbagliArcangelo Bartoccini, Teresa Bartoli, Francesco Bassi, Eduardo Beck, Umberto Giuseppe Belloni, Maurizio Berardino, Maria Olga Bernasconi, Andrea Bianchin, Angelo Blasetti, Daniela Boccalatte-Rosa, Giuseppina Bonaccorso, Andrea Bonfà, Monica Bonfiglio, Manuela Bonizzoli, Valter Bottari, Cesare Breschi, Silvia Bressan, Emanuela Brunori, Gaetano Burgio, Virginio Buzzetti, Gian Virgilio Cabano, Giuseppe Calicchio, Massimo Caracciolo, Sergio Casagli, Lucia Casagrande, Massimo Casciani, Giacomo Castiglione, Renata Cavallo, Marco Chiarello, Arturo Chieregato, Elena Chinelli, Giuseppe Chini, Stefano Clemente, Maddalena Coaloa, Riccardo Colombo, Salvatore Silvio Colonna, Silvano Cominotti, Walter Corsini, Eleonora Constanzo, Luciano Crema, Ezio Crestan, Paulo Dal Cero, Marino Dal Ferro, Luigi Dal Poggetto, Lucia Dal Pos, Antonio David, Roberto Alberto De Blasi, Alessandra De Luca, Pasquale De Negri, Marco Dei Poli, Paolo Del Sarto, Pierfrancesco Di Masi, Dino Di Pasquale, De Blasio Elvio, Emilio Fabbri, Lea Fabbri, Pier Giorgio Fabbri, Maria Cristina Fabi, Luciana Faccio, Anotnio Falconio, Simonetta Fasiolo, Paolo Febbrari, Marco Ferrante, Fausto Ferraro, Gilberto Fiore, Carlotta Fontaneto, Rita Gabini, Elsa Galeotti, Emiliano Gamberini, Alberto Garelli, Giuseppe Garofalo, Luigi Giacopuzzi, Massimo Gianni, Stefano Giannoni, Massimo Girardis, Daniela Giudici, Pier Mario Giugiaro, Adonella Gorietti, Paolo Grassi

Research output: Contribution to journalArticlepeer-review

Abstract

Aim. The assessment of the quality of intensive care medicine is mandatory in the modern healthcare system. In Italy, the GiViTI (Gruppo Italiano per la Valutazione degli Interventi in Terapia Intensiva) network is working in this field since 1991 and it now involves 295 out of the about 450 Italian intensive care units (ICU). In 2002 GiViTI launched a project for the continuous quality assessment and improvement that is now joined by 180 ICUs. Data collected in 2005 are analyzed and presented. Methods. All admitted patients were entered in a validated software, which performs a multitude of validity checks during the data entry. Data were further reviewed by the co-ordinating center; patients admitted in months with more than 10% of incomplete or inconsistent records in each ICU were excluded from the analysis. Each year, a multivariate logistic regression model is fitted to identify predictors of hospital mortality. Starting from the SAPS 2 and the 2004 GiViTI model predictions of hospital mortality, two calibration tables and curves are presented. Results. In 2005, 180 Italian ICUs collected data on 55 246 patients. After excluding those admitted in months with an unjustified lower recruitment rate or with less than 90% of complete and consistent data, we had 52 816 (95.6%) valid cases. Although the rough hospital mortality in 2005 was 1% higher than in 2004 (22.6% vs 21.5%), the adjusted mortality shows a statistically significant 4% reduction (obser-ved-to-expected ratio: 0.96; 95% CI: 0.94-0.97). Conclusion. Italian ICUs in 2005 performed better than in 2004, at a parity of patient severity.

Original languageEnglish
Pages (from-to)419-432
Number of pages14
JournalMinerva Anestesiologica
Volume72
Issue number6
Publication statusPublished - Jun 2006

Keywords

  • Gruppo Italiano per la Valutazione degli Interventi in Terapia Intensiva
  • Intensive Care Units
  • Quality

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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