Monitoring the performance of intensive care units using the variable life-adjusted display: a simulation study to explore its applicability and efficiency

摘要: Rationale, aims and objectives  Graphical monitoring tools are needed for real-time quality evaluation in intensive care unit. The variable life-adjusted display (VLAD) provides a directly interpretable assessment indicating whether the overall performance is better or worse than expected on basis of predicted risk failure. aim this study to quantify ability VLAD charts early recognize worsening clinical performance. Methods  A Monte Carlo experiment simulating sequence successes failures an unit performed; mortality calculated by means Simplified Acute Physiology Score 3 admission score. From given position admissions sequence, we increased probability death; calculated: (i) surveillance system delay responding increase; (ii) percentage cases where has been able give alarm within first 5, 10, 20 60 deaths occurred after increase (iii) false declarations (anticipated alarms). Results  frequency distribution delays shows was not always detect increase. Only very small number anticipated alarms were given. Conclusions  Variable signal mild strictly correlated with institution volume activity. Therefore, use seems be advisable, integration between other well-documented as CUSUM could preferable.