Process monitoring in intensive care with the use of cumulative expected minus observed mortality and risk-adjusted p charts 英文参考文献.docVIP

Available online /content/10/1/R28 Research Open Access Vol 10 No 1 Process monitoring in intensive care with the use of cumulative expected minus observed mortality and risk-adjusted p charts Jerome GL Cockings1, David A Cook2 and Rehana K Iqbal3 1Department of Intensive Care Medicine, Royal Berkshire Hospital, Reading, Berkshire RG1 5AN, UK 2Intensive Care Unit, Princess Alexandra Hospital, Brisbane, Queensland, Australia Ipswich Road, Wooloongabba, Brisbane QLD, 4000, Australia 3Department of Intensive Care Medicine, Royal Berkshire Hospital, Reading, Berkshire RG1 5AN, UK Corresponding author: Jerome GL Cockings, jerome.cockings@rbbh-tr.nhs.uk Received: 30 Aug 2005 Revisions requested: 13 Oct 2005 Revisions received: 7 Dec 2005 Accepted: 18 Jan 2006 Published: 14 Feb 2006 Critical Care 2006, 10:R28 (doi:10.1186/cc3996) This article is online at: /content/10/1/R28 ? 2006 Cockings et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Introduction A health care system is a complex adaptive system. The effect of a single intervention, incorporated into a complex clinical environment, may be different from that expected. A national database such as the Intensive Care National Audit Research Centre (ICNARC) Case Mix Programme in the UK represents a centralised monitoring, surveillance and reporting system for retrospective quality and comparative audit. This can be supplemented with real-time process monitoring at a local level for continuous process improvement, allowing early detection of the impact of both unplanned and deliberately imposed changes in the clinical environment. show how they can be used to detect planned or unplanned