Measuring Clinical Information Technology in the ICU Setting: Application in a Quality Improvement Collaborative

Ruben Amarasingham, Peter J. Pronovost, Marie Diener-West, Christine Goeschel, Todd Dorman, David R. Thiemann, Neil R. Powe

Research output: Contribution to journalArticle

27 Scopus citations

Abstract

Objective: Few instruments are available to measure the performance of intensive care unit (ICU) clinical information systems. Our objectives were: 1) to develop a survey-based metric that assesses the automation and usability of an ICU's clinical information system; 2) to determine whether higher scores on this instrument correlate with improved outcomes in a multi-institution quality improvement collaborative. Design: This is a cross-sectional study of the medical directors of 19 Michigan ICUs participating in a state-wide quality improvement collaborative designed to reduce the rate of catheter-related blood stream infections (CRBSI). Respondents completed a survey assessing their ICU's information systems. Measurements: The mean of 54 summed items on this instrument yields the clinical information technology (CIT) index, a global measure of the ICU's information system performance on a 100 point scale. The dependent variable in this study was the rate of CRBSI after the implementation of several evidence-based recommendations. A multivariable linear regression analysis was used to examine the relationship between the CIT score and the post-intervention CRBSI rates after adjustment for the pre-intervention rate. Results: In this cross-sectional analysis, we found that a 10 point increase in the CIT score is associated with 4.6 fewer catheter related infections per 1,000 central line days for ICUs who participate in the quality improvement intervention for 1 year (95% CI: 1.0 to 8.0). Conclusions: This study presents a new instrument to examine ICU information system effectiveness. The results suggest that the presence of more sophisticated information systems was associated with greater reductions in the bloodstream infection rate.

Original languageEnglish (US)
Pages (from-to)288-294
Number of pages7
JournalJournal of the American Medical Informatics Association
Volume14
Issue number3
DOIs
StatePublished - May 2007

ASJC Scopus subject areas

  • Health Informatics

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    Amarasingham, R., Pronovost, P. J., Diener-West, M., Goeschel, C., Dorman, T., Thiemann, D. R., & Powe, N. R. (2007). Measuring Clinical Information Technology in the ICU Setting: Application in a Quality Improvement Collaborative. Journal of the American Medical Informatics Association, 14(3), 288-294. https://doi.org/10.1197/jamia.M2262