Results of 1st Cycle Assessment and auto-evaluation of the C.A.F. implementation, in the ICU of G.H of Trikala
Journal: The Greek E-Journal of Perioperative Medicine (Vol.15, No. 1)Publication Date: 2016-09-15
Authors : Pagaki E; Pagdatoglou K; Τsioka A; Koukoubani T; Efthimiadi A.; Stavrothanasopoulou A; Kouloumoundri V; Siafi M; Papapostolou G; Bouga E; Pagouni E; K atsiakou Ch; Moriki S; Tasios Th; Katsi Ch; Ilioudi S; Tsigas A; Bairachtaris G; ParaforouTh.;
Page : 2-18
Keywords : C.A.F; Quality; SRU; SMR; Bench?marking;
Abstract
After the implementation of Common Assessment Framework (CAF) ? a useful quality tool ? in the ICU of General Hospital of Trikala from 2012 up to 2015, we integrated the first cycle of self assessment and we present our results and conclusions of the past 3-year-period (2012- 2013 -2014). We analyzed CAF, FS- ICU 24, TISS-28 and Burn out syndrome questionnaires and medical indicators as Standardized mortality rate (SMR), Length of Stay (LOS), Standardized Resource Use (SRU), SMR/SRU, Therapeutic intervention scoring system (TISS-28), TISS-28/days of hospitalization, Nurse/Patient ratio, cost indicators and mortality. Analyzing the CAF questionnaire the score was 2.5-3.5, counting the indicator TISS-28 we found an average value higher than 50, concerning the burn-out syndrome questionnaire it was found that 58.82% of the respondent employees working in the ICU had mild symptoms of the syndrome. We analyzed the true Level of ICU (TISS-28/days of hospitalization) with the Level of ICU (nurse /patient ratio) and we found that they were not alike. We found an increase of mortality rate and LOS (length of stay) during the period of 2011 ?2015 but a gradual reduction of the SMR/SRU indicator (the whole period ? 1) and a decline of the average cost/ patient and the average cost/ day of hospitalization. We found that in some criteria of CAF questionnaire, programming and implementation of the action plan exists and in some other criteria there is also inspection. It was found that in all 8 hour shifts of the nurse personnel, the value was high mainly due to lack of personnel. We found that the work load of the nurse personnel in relation to the condition of the critically ill patients was heavier during the night shifts and the true Level of ICU (TISS-28/days of hospitalization) with the Level of ICU (nurse /patient ratio) were not alike, perhaps because the nurse/patient ratio doesn't include the critical state and the severity of the patient's illness. The cost of service declined. The gradual reduction of the SMR/SRU indicator (the hole period ? 1) means that our ICU is functional has a low mortality rate compared with the expected and the cost is still in good levels. At the end, we came up with useful conclusions concerning the quality of health service provided by our ICU and how we can further improve our weak points in order to become better.
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