ArticleCritical care (London, England)2020
Effects of a national quality improvement program on ICUs in China: a controlled pre-post cohort study in 586 hospitals.
Article in Critical care (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Analysis of structure indicators influencing 3-h and 6-h compliance with the surviving sepsis campaign guidelines in China: a systematic review.European journal of medical research · 2021Pooled it
- Drivers of improved prognosis in pediatric sepsis in China: policy support and collaborative actions.Frontiers in pediatrics · 2026Article
- ICU capacity, ICU staffing, and postcardiotomy ECMO outcomes in China: a multilevel cross-sectional study.Critical care (London, England) · 2025Article
- Evaluation of a Global Initiative for Asthma Education and Implementation Program to Improve Asthma Care Quality (CARE4ALL): Protocol for a Multicenter, Single-Arm Study.JMIR research protocols · 2025Article
- Association between ICU quality and in-hospital mortality of V-V ECMO-supported patients-the ECMO quality improvement action (EQIA) study: a national cohort study in China from 2017 to 2019.Frontiers of medicine · 2024Article
- Evaluation of ICUs and weight of quality control indicators: an exploratory study based on Chinese ICU quality data from 2015 to 2020.Frontiers of medicine · 2023Article
- Association between quality control and outcomes of septic shock caused by intestinal perforation in China: a cross-sectional study.Scientific reports · 2023Observational
- Letter to the Editor regarding "Effect of ICU quality control indicators on VAP incidence rate and mortality: a retrospective study of 1267 hospitals in China".Critical care (London, England) · 2023Article
- Impact of Nosocomial Infection on in-Hospital Mortality Rate in Adult Patients Under Venoarterial Extracorporeal Membrane Oxygenation After Cardiac Surgery.Infection and drug resistance · 2023Article
- Effect of ICU quality control indicators on VAP incidence rate and mortality: a retrospective study of 1267 hospitals in China.Critical care (London, England) · 2022Article
- Association of annual hospital septic shock case volume and hospital mortality.Critical care (London, England) · 2022Article
- The story of critical care in Asia: a narrative review.Journal of intensive care · 2021Review
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13 authors.
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Abstract
introductionPatient safety and critical care quality remain a challenging issue in the ICU. However, the effects of the national quality improvement (QI) program remain unknown in China.
methodsA national ICU QI program was implemented in a controlled cohort of 586 hospitals from 2016 to 2018. The effects of the QI program on critical care quality were comprehensively investigated. MAIN
resultsA total of 81,461,554 patients were enrolled in 586 hospitals, and 1,587,724 patients were admitted to the ICU over 3 years. In 2018, there was a significantly higher number of ICU beds (2016 vs. 2018: 10668 vs. 13,661, P = 0.0132) but a lower doctor-to-bed ratio (2016 vs. 2018: 0.64 (0.50, 0.83) vs. 0.60 (0.45, 0.75), P = 0.0016) and nurse-to-bed ratio (2016 vs. 2018: 2.00 (1.64, 2.50) vs. 2.00 (1.50, 2.40), P = 0.031) than in 2016. Continuous and significant improvements in the ventilator-associated pneumonia (VAP) incidence rate, microbiology detection rate before antibiotic use and deep vein thrombosis (DVT) prophylaxis rate were associated with the implementation of the QI program (VAP incidence rate (per 1000 ventilator-days), 2016 vs. 2017 vs. 2018: 11.06 (4.23, 22.70) vs. 10.20 (4.25, 23.94) vs. 8.05 (3.13, 17.37), P = 0.0002; microbiology detection rate before antibiotic use (%), 2016 vs. 2017 vs. 2018: 83.91 (49.75, 97.87) vs. 84.14 (60.46, 97.24) vs. 90.00 (69.62, 100), P < 0.0001; DVT prophylaxis rate, 2016 vs. 2017 vs. 2018: 74.19 (33.47, 96.16) vs. 71.70 (38.05, 96.28) vs. 83.27 (47.36, 97.77), P = 0.0093). Moreover, the 6-h SSC bundle compliance rates in 2018 were significantly higher than those in 2016 (6-h SSC bundle compliance rate, 2016 vs. 2018: 64.93 (33.55, 93.06) vs. 76.19 (46.88, 96.67)). A significant change trend was not found in the ICU mortality rate from 2016 to 2018 (ICU mortality rate (%), 2016 vs. 2017 vs. 2018: 8.49 (4.42, 14.82) vs. 8.95 (4.89, 15.70) vs. 9.05 (5.12, 15.80), P = 0.1075).
conclusionsThe relationship between medical human resources and ICU overexpansion was mismatched during the past 3 years. The implementation of a national QI program improved ICU performance but did not reduce ICU mortality.
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