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Unless your software program allows you to analyze data easily, the numbers it stores are of little use, says R. Phillip Dellinger, MD, FCCM, FCCP. He is director of critical care at Rush Medical College, Rush Presbyterian-St. Luke’s Medical Center in Chicago and Cook County Hospital, and former president of the Society for Critical Care Medicine (SCCM). Dellinger says that the first edition of SCCM’s Project Impact (PI) software had some serious shortcomings because it was not constructed to talk with other databases easily within the same hospital. "The current PI software is much more user-friendly," Dellinger says.
The PI update became available about 6 months ago. Dellinger says the software update makes it easier for an institution to do local analyses of the database, for example, comparing lengths of stays for upper GI bleeders with cirrhosis as opposed to upper GI bleeders without.
"The new program also makes it easy to pull data gathered earlier from other systems within the hospital into the PI database," Dellinger says. "We could do this before, but it required specially written software programs that were very laborious to use and it was too tough for widespread application."
Dellinger says his facility is currently rewording diagnoses to conform to CPT and ICD-9 codes because doing so will allow comparisons with more databases. For instance, if your outcome on a specific condition is the same but the length of stay is significantly greater, the database could tell you that another institution has the same utilization-based clinical outcome but doesn’t do something you regularly do. That could tell you something about what effect making that change would have on your data. If you’re an outlier for clinical outcome or resource use you can see what you do differently than the database in general.
The software includes data on admissions and discharge, demographics, ICU data, data on pre-existing diseases, procedures, therapies, and outcomes. PI Director Meg Wilson says SCCM developed the elements of the software program so that an ICU can use its own intensivists to create a local database. "Our members saw a need for ICUs to have a database on local admissions so that over time they could compare themselves to themselves, and see which protocols instituted actually provided better patient outcomes," she says.
Each quarter, institutions that participate in PI are required to send the patient information to a central registry. Wilson says that the software complies with all confidentiality requirements by stripping patient and physician identifiers, leaving the information identifiable only by a number. "We then aggregate the data and provide back to each ICU a quarterly confidential report that compares the reporting unit to similar units and patient mix to the national database," Wilson says.
Current costs for PI are $4000 annually plus $500 for each licensed ICU bed. Contact Meg Wilson at (800) 458-2674 for further information.