Linking of global intensive care (LOGIC): An international benchmarking in critical care initiative.

D.A Dongelmans,Ariel Fernandez,Marcio Soares,Abigail Beane,Bertrand Guidet,Maria Del Pilar Arias Lopez,Jorge I.F Salluh,Rashan Haniffa,David Pilcher

doi:10.1016/j.jcrc.2020.08.031

Abstract

Benchmarking is a common and effective method for measuring and analyzing ICU performance. With the existence of national registries, objective information can now be obtained to allow benchmarking of ICU care within and between countries. The present manuscript briefly describes the current status of benchmarking in healthcare and critical care and presents the LOGIC project, an initiative to promote international benchmarking for intensive care units. Currently 13 registries have joined LOGIC. We showed large differences in the utilization of ICU as well as resources and in outcomes. Despite the need for careful interpretation of differences due to variation in definitions and limited risk adjustment, LOGIC is a growing worldwide initiative that allows access to insightful epidemiologic data from ICUs in multiple databases and registries.

Highlights

The complexity and costs of critical care delivery are a large burden on healthcare systems
The present manuscript briefly describes the current status of benchmarking in healthcare and critical care and presents the LOGIC project, an initiative to promote international benchmarking for intensive care units
After being officially launched with the participation of ANZICSCORE (Australia and New Zealand), Epimed (Brazil, Belgium, Colombia, Uruguay), Critical Care Asia (CCA: Sri Lanka) and NICE (Netherlands), other registries promptly joined such as SATI-Q Programme (Argentina), E-Alberta critical care (Alberta region, Canada), CUB-Réa

Summary

Introduction

The complexity and costs of critical care delivery are a large burden on healthcare systems. It is crucial to understand the outcomes related to an intensive care admission [1] This is not a simple task and involves several complex aspects including, but not limited to, definitions of crude outcomes, patient-reported or patient centered metrics, costs and adherence to evidence-based care measures [2,3]. Intensivists and policy makers agree that measuring and tracking data and results of care provided in an Intensive Care Unit (ICU) is key to understanding its quality and identifying targets for improvement. Implementation of research, evidence-based processes of care and datadriven management at ICUs locally and nationally. They have become a paramount source for benchmarking in critical care. The present manuscript briefly describes the current status of benchmarking in healthcare and critical care and presents the LOGIC project, an initiative to promote international benchmarking for intensive care units

Benchmarking in healthcare

The current and future role of global ICU registries in benchmarking

The LOGIC project

Challenges

Examples of global initiatives that succeeded

Conclusions