• Marie-José Roos-Blom, Ferishta Bakhshi-Raiez, Sylvia Brinkman, M Sesmu Arbous, Roy van den Berg, Rob J Bosman, Bas C T van Bussel, Michiel L Erkamp, Mart J de Graaff, Marga E Hoogendoorn, Dylan W de Lange, David Moolenaar, Jan Jaap Spijkstra, de WaalRuud A LRALNational Intensive Care Evaluation Foundation, Amsterdam, the Netherlands; Amphia Hospital, Intensive Care Medicine, Molengracht 21, 4818 CK Breda, the Netherlands., Dave A Dongelmans, and Nicolette F de Keizer.
• Amsterdam UMC location University of Amsterdam, Department of Medical Informatics, Meibergdreef 9, Amsterdam, the Netherlands; National Intensive Care Evaluation Foundation, Amsterdam, the Netherlands; Amsterdam Public Health, Quality of Care, Amsterdam, the Netherlands. Electronic address: m.blom@amsterdamumc.nl.
• J Crit Care. 2024 Feb 1; 79: 154461154461.

PurposeTo investigate the development in quality of ICU care over time using the Dutch National Intensive Care Evaluation (NICE) registry.Materials And MethodsWe included data from all ICU admissions in the Netherlands from those ICUs that submitted complete data between 2009 and 2021 to the NICE registry. We determined median and interquartile range for eight quality indicators. To evaluate changes over time on the indicators, we performed multilevel regression analyses, once without and once with the COVID-19 years 2020 and 2021 included. Additionally we explored between-ICU heterogeneity by calculating intraclass correlation coefficients (ICC).Results705,822 ICU admissions from 55 (65%) ICUs were included in the analyses. ICU length of stay (LOS), duration of mechanical ventilation (MV), readmissions, in-hospital mortality, hypoglycemia, and pressure ulcers decreased significantly between 2009 and 2019 (OR <1). After including the COVID-19 pandemic years, the significant change in MV duration, ICU LOS, and pressure ulcers disappeared. We found an ICC ≤0.07 on the quality indicators for all years, except for pressure ulcers with an ICC of 0.27 for 2009 to 2021.ConclusionsQuality of Dutch ICU care based on seven indicators significantly improved from 2009 to 2019 and between-ICU heterogeneity is medium to small, except for pressure ulcers. The COVID-19 pandemic disturbed the trend in quality improvement, but unaltered the between-ICU heterogeneity.Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.

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