Pathway mapping ICU care - analysis of deidentified retrospective data
Research type
Research Study
Full title
Pathway mapping to identify targets for improvement in critical care. A pathway mapping study using retrospective deidentified data from a single centre.
IRAS ID
285865
Contact name
Alwyn Kotze
Contact email
Sponsor organisation
Leeds Teaching Hospitals
Duration of Study in the UK
0 years, 3 months, 1 days
Research summary
Intensive Care Units (ICU) are high-cost areas of acute hospitals where patients are closely monitored and treatments administered which are not possible in normal wards. An overall shortage of ICU beds and day-to-day mismatch between supply and demand lead to increasing cancelled operations. Patients on ICUs may suffer from "shock" which is defined as inadequate oxygen delivery to vital tissues. Treatment includes intravenous fluid as well as medicines that affect the heart and blood vessels. Current treatment targets are based on whole-body variables e.g. blood pressure or cardiac output. However, it is the disturbance at tissue level that ultimately causes harm, and different tissues may be affected differently by shock.
Recovered ICU patients are discharged to normal wards. Unplanned readmissions are often longer and more expensive than the primary admission and outcomes for patients are poorer. It is thus very important to time ICU discharges appropriately. The University of Leeds have developed a pathway mapping and data visualisation tool - NETIMIS. The software allows clinical teams to map out the care received by individual patients and simulate patient flow across time. This allows visualisation & understanding of overall capacity issues and day-to-day mismatches which can be difficult to capture using traditional quantitative methods. In particular, the impact of readmissions on daily bed state can be considered.
We will use NETIMIS to analyse deidentified retrospective data provided by Leeds Teaching Hospitals, in accordance with their established processes for data deidentification and prevention of subsequent reidentification. We will use the maps and simulations to conduct semi-structured interviews with volunteer staff members to identify and quantify possible benefits, if the treatment of shock could be improved. The intention is to inform the design of a study looking at a novel end point for shock treatment, for which we will seek separate ethical & regulatory approval.
REC name
N/A
REC reference
N/A