Quality of care (IT systems)

What we do

Within this research line, we are working on improving healthcare and preventing errors. This is achieved by developing quality indicators, case mix correction, comparing various hospitals, and providing feedback to healthcare providers. This feedback allows to enhance their behavior and/or care processes.

Aim

We aim to reuse routinely collected data to improve quality of care. We primarily focus on the intensive care, but we also have projects in other specialties and in healthcare systems of low- and middle income countries, for example in Asia and Africa.

Contact

More information: NICE registry

Appropriate ICU care

The growing demand for healthcare calls for more appropriate and efficient care in Dutch intensive care units (ICUs). This project uses nationwide data analyses, e.g. combining NICE data with data form Statistics Netherlands (CBS), to identify where ICU care can be better aligned with patients’ needs. We aim to gain new insights into long-term healthcare dependency after ICU discharge and to develop ICU-level benchmarks that can be used to highlight opportunities for more appropriate care across ICUs in the Netherlands.

KIK Staff: Niels van der Heijden, Ferishta Raiez, Nicolette de Keizer, Fabian Termorshuizen

Effectiveness in Clinical Decision Support SystemsEQUAL

This research line investigates the design of effective CDSS, barriers and facilitators to its use, and methods for evaluating CDSS, and its additional value to audit and feedback interventions. The projects originate often via collaboration with other research lines within and outside the department.

Stephanie “Ace” Medlock, Joanna Klopotowska, Ameen Abu-Hana

NICE Federated Learning

This project tests the feasibility of Federated Learning, a decentralized machine learning technique. We will examine the performance of NICE’s yearly APACHE IV recalibration when calculated centralized versus decentralized (recreated virtually) and investigate its effect on the position of ICUs in funnel plots.

KIK Staff: Ferishta Raiez, Sebastian van der Voort, Ronald Cornet, Nicolette de Keizer

NICE2Improve Antibiotics

In the ICU, 30% to 60% of the antibiotics are prescribed unnecessary, inappropriate, or suboptimal. This project aims to develop and evaluate a NICE2Improve dashboard for antibiotics. The dashboard includes actionable quality indicators and a toolbox with suggestions of improvement actions to support ICU staff on how they can increase appropriate antibiotics use.

KIK Staff: Daphne Stegink, Marie-José Blom, Nicolette de Keizer, Anne Langermans, Joanna Klopotowska

Reusing routinely collected physiological data

NICE collects physiological variables deviating most from ‘normal values’ (extreme values) of patients admitted to ICUs. These variables are needed, among other variables, to calculate the APACHE IV mortality risk. This research project aims to ‘predict’ these extremes from monitor data collected continuously during the first 24 hours of an ICU stay, to replace manual work and reduce variability among ICUs.

KIK Staff: Roos Bulthuis, Ferishta Raiez, Fabian Termorshuizen

SES and ICU outcomes

Generally, a lower socioeconomic status (SES) is associated with more adverse healthcare outcomes. This nationwide observational cohort study will investigate SES in the total Dutch ICU population and across regions, the association between SES and (hospital/long-term) mortality, and its effect on individual estimated mortality risks.  

KIK Staff: Danielle Koorneef, Sylvia Brinkman, Fabian Termorshuizen, Nicolette de Keizer