Evidence map›Paper›PMID 37954925›Full record

ArticleWellcome open research2023

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.

Collaboration for Research, Implementation and Training in Critical Care in Asia and Africa (CCAA), Aasiyah Rashan, Abi Beane, Aniruddha Ghose, Arjen M Dondorp, Arthur Kwizera, Bharath Kumar Tirupakuzhi Vijayaraghavan, Bruce Biccard, Cassia Righy, C Louise Thwaites and 35 more

Abstract read
In one paragraph

Article in Wellcome open research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

45 authors.

Collaboration for Research, Implementation and Training in Critical Care in Asia and Africa (CCAA)
Aasiyah RashanInstitute of Health Informatics, University College London, London, UK.ORCID https://orcid.org/0000-0002-7456-4322
Abi BeaneCentre for Inflammation Research, University of Edinburgh, Edinburgh, UK.ORCID https://orcid.org/0000-0001-7046-1580
Aniruddha GhoseDepartment of Medicine, Chittagong Medical College Hospital, Chattogram, Bangladesh.ORCID https://orcid.org/0000-0002-5551-6691
Arjen M DondorpMahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand.ORCID https://orcid.org/0000-0001-5190-2395
Arthur KwizeraDepartment of Anaesthesia and Intensive Care Medicine, Makerere University, Kampala, Uganda.
Bharath Kumar Tirupakuzhi VijayaraghavanDepartment of Critical Care Medicine, Apollo Hospitals Educational and Research Foundation, Chennai, India.ORCID https://orcid.org/0000-0002-1801-0667
Bruce BiccardDepartment of Anaesthesia and Perioperative Medicine, University of Cape Town, Cape Town, South Africa.
Cassia RighyNational Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.ORCID https://orcid.org/0000-0002-9206-9552
C Louise ThwaitesNuffield Department of Medicine, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0002-4666-9813
Christopher PellAmsterdam Institute for Global Health and Development, Amsterdam, The Netherlands.
Cornelius SendagireUganda Heart Institute, University of Makerere, Makerere, Uganda.
David ThomsonDepartment of Anaesthesia and Perioperative Medicine, University of Cape Town, Cape Town, South Africa.ORCID https://orcid.org/0000-0003-2433-3611
Dilanthi Gamage DoneNat-Intensive Care Surveillance, Mahidol Oxford Tropical Medicine Research Unit, Colombo, Sri Lanka.ORCID https://orcid.org/0000-0003-4058-7670
Diptesh AryalMahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand.ORCID https://orcid.org/0000-0002-1431-8293
Duncan WagstaffDepartment of Anaesthesia and Perioperative Medicine, University of Cape Town, Cape Town, South Africa.
Farah NadiaDepartment of Intensive Care Anaesthesiology, International Islamic University Malaysia, Kuala Lumpur, Malaysia.ORCID https://orcid.org/0000-0002-4383-0464
Giovanni PutotoDepartment of Planning and Operational Research, Doctors with Africa CUAMM, Padova, Italy.
Hem PanaruDepartment of Critical Care, Nepal Intensive Care Research Foundation, Kathmandu, Nepal.ORCID https://orcid.org/0000-0002-3487-5388
Ishara UdayangaNat-Intensive Care Surveillance, Mahidol Oxford Tropical Medicine Research Unit, Colombo, Sri Lanka.ORCID https://orcid.org/0000-0003-2568-1386
John AmuasiDepartment of Global Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.ORCID https://orcid.org/0000-0002-8640-2662
Jorge SalluhD'Or Institute for Research and Education, Sao Paulo, Brazil.ORCID https://orcid.org/0000-0002-8164-1453
Krishna GokhaleInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Krishnarajah NirantharakumarInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Luigi PisaniMahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand.ORCID https://orcid.org/0000-0001-7177-3594
Madiha HashmiMahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand.ORCID https://orcid.org/0000-0002-7332-0692
Marcus SchultzIntensive Care Medicine, University of Amsterdam, Amsterdam, The Netherlands.ORCID https://orcid.org/0000-0003-3969-7792
Maryam Shamal GhalibGeneral Surgery, Wazir Akbar Khan Hospital, Kabul, Afghanistan.ORCID https://orcid.org/0000-0002-3674-8083
Mavuto MukakaMahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand.
Mohammed Basri Mat-NorDepartment of Intensive Care Anaesthesiology, International Islamic University Malaysia, Kuala Lumpur, Malaysia.ORCID https://orcid.org/0000-0002-5433-6357
Moses Siaw-FrimpongDepartment of Anaesthesiology and Intensive care, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
Rajendra SurenthirakumaranDepartment of Community and Family Medicine, University of Jaffna, Jaffna, Sri Lanka.
Rashan HaniffaCentre for Inflammation Research, University of Edinburgh, Edinburgh, UK.ORCID https://orcid.org/0000-0002-8288-449X
Ronnie P KadduDepartment of Anaesthesia, The Aga Khan University, Nairobi, Kenya.
Snehal Pinto PereiraDepartment of Targeted Intervention, University College London, London, UK.ORCID https://orcid.org/0000-0002-0876-8757
Srinivas MurthyDepartment of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
Steve HarrisDepartment of Critical Care, University College London Hospitals NHS Foundation Trust, London, UK.
Suneetha Ramani MoonesingheDepartment of Targeted Intervention, University College London, London, UK.
Sutharshan VengadasalamTeaching Hospital Jaffna, Jaffna, Sri Lanka.
Swagata TripathyCentre for Inflammation Research, University of Edinburgh, Edinburgh, UK.ORCID https://orcid.org/0000-0002-5315-6477
Tiffany E GoodenInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.ORCID https://orcid.org/0000-0001-8252-8076
Timo TolppaNat-Intensive Care Surveillance, Mahidol Oxford Tropical Medicine Research Unit, Colombo, Sri Lanka.ORCID https://orcid.org/0000-0002-4119-7335
Vrindha PariChennai Critical Care Consultants Private Limited, Chennai, India.
Wangari Waweru-SiikaDepartment of Anaesthesia, The Aga Khan University, Nairobi, Kenya.ORCID https://orcid.org/0000-0002-3045-3372
Yen Lam MinhOxford University Clinical Research Unit, University of Oxford, Ho Chi Minh City, Vietnam.

Funding

Medical Research Council MR/P020372/1Medical Research Council MR/V030884/1Wellcome Trust
6 · The paper itself

Abstract

Background: Improved access to healthcare in low- and middle-income countries (LMICs) has not equated to improved health outcomes. Absence or unsustained quality of care is partly to blame. Improving outcomes in intensive care units (ICUs) requires delivery of complex interventions by multiple specialties working in concert, and the simultaneous prevention of avoidable harms associated with the illness and the treatment interventions. Therefore, successful design and implementation of improvement interventions requires understanding of the behavioural, organisational, and external factors that determine care delivery and the likelihood of achieving sustained improvement. We aim to identify care processes that contribute to suboptimal clinical outcomes in ICUs located in LMICs and to establish barriers and enablers for improving the care processes. Methods: Using rapid evaluation methods, we will use four data collection methods: 1) registry embedded indicators to assess quality of care processes and their associated outcomes; 2) process mapping to provide a preliminary framework to understand gaps between current and desired care practices; 3) structured observations of processes of interest identified from the process mapping and; 4) focus group discussions with stakeholders to identify barriers and enablers influencing the gap between current and desired care practices. We will also collect self-assessments of readiness for quality improvement. Data collection and analysis will be led by local stakeholders, performed in parallel and through an iterative process across eight countries: Kenya, India, Malaysia, Nepal, Pakistan, South Africa, Uganda and Vietnam. Conclusions: The results of our study will provide essential information on where and how care processes can be improved to facilitate better quality of care to critically ill patients in LMICs; thus, reduce preventable mortality and morbidity in ICUs. Furthermore, understanding the rapid evaluation methods that will be used for this study will allow other researchers and healthcare professionals to carry out similar research in ICUs and other health services.

Indexed as

critical illnessintensive carelearning health systemslow- and middle-income countriesquality of carerapid evaluation

Identifiers

PMID37954925
PMCPMC10638482

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.