ArticleIntensive care medicine2022
Development of a quality indicator set to measure and improve quality of ICU care in low- and middle-income countries.
Article in Intensive care medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Development and 2025 re-evaluation of a Japanese quality indicator set for adult intensive care: a modified RAND/UCLA Delphi study.Journal of intensive care · 2026Article
- Contextual determinants of implementation of stakeholder-selected quality indicators in Indian intensive care units: a mixed-methods evaluation within a national registry network.Frontiers in health services · 2026Article
- A rapid evaluation of quality of sedation and ventilation care processes for critically ill patients in Vietnam.PloS one · 2026Article
- Toward Standardized Performance Metrics in the Cardiovascular ICU: A Systematic Review of Quality Indicators.Cureus · 2025Review
- Patient safety culture in resource-limited healthcare settings: A multicentre survey.PloS one · 2025Article
- Implementing an ICU registry in Ethiopia-Implications for critical care quality improvement.Journal of critical care · 2024Article
- Scientific output and organizational characteristics in Brazilian intensive care units: a multicenter cross-sectional study.Critical care science · 2024Article
- A health systems approach to critical care delivery in low-resource settings: a narrative review.Intensive care medicine · 2023Review
- Mixed methods study protocol for combining stakeholder-led rapid evaluation with near real-time continuous registry data to facilitate evaluations of quality of care in intensive care units.Wellcome open research · 2023Article
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2 authors.
Funding
Abstract
purposeTo develop a set of actionable quality indicators for critical care suitable for use in low- or middle-income countries (LMICs).
methodsA list of 84 candidate indicators compiled from a previous literature review and stakeholder recommendations were categorised into three domains (foundation, process, and quality impact). An expert panel (EP) representing stakeholders from critical care and allied specialties in multiple low-, middle-, and high-income countries was convened. In rounds one and two of the Delphi exercise, the EP appraised (Likert scale 1-5) each indicator for validity, feasibility; in round three sensitivity to change, and reliability were additionally appraised. Potential barriers and facilitators to implementation of the quality indicators were also reported in this round. Median score and interquartile range (IQR) were used to determine consensus; indicators with consensus disagreement (median < 4, IQR ≤ 1) were removed, and indicators with consensus agreement (median ≥ 4, IQR ≤ 1) or no consensus were retained. In round four, indicators were prioritised based on their ability to impact cost of care to the provider and recipient, staff well-being, patient safety, and patient-centred outcomes.
resultsSeventy-one experts from 30 countries (n = 45, 63%, representing critical care) selected 57 indicators to assess quality of care in intensive care unit (ICU) in LMICs: 16 foundation, 27 process, and 14 quality impact indicators after round three. Round 4 resulted in 14 prioritised indicators. Fifty-seven respondents reported barriers and facilitators, of which electronic registry-embedded data collection was the biggest perceived facilitator to implementation (n = 54/57, 95%) Concerns over burden of data collection (n = 53/57, 93%) and variations in definition (n = 45/57, 79%) were perceived as the greatest barrier to implementation.
conclusionThis consensus exercise provides a common set of indicators to support benchmarking and quality improvement programs for critical care populations in LMICs.
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