• Oliver Kumpf, Frank Bloos, Hanswerner Bause, Alexander Brinkmann, Maria Deja, Gernot Marx, Arnold Kaltwasser, Rolf Dubb, Elke Muhl, Clemens-A Greim, Norbert Weiler, Ines Chop, Günther Jonitz, Henning Schaefer, Matthias Felsenstein, Ursula Liebeskind, Carsten Leffmann, Annemarie Jungbluth, Christian Waydhas, Peter Pronovost, Claudia Spies, Jan-Peter Braun, and NeQuI-Group (Netzwerk Qualität in der Intensivmedizin).
• Department of Anaesthesiology and Intensive Care Medicine, Campus Charité Mitte and Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Germany.
• Ger Med Sci. 2014 Jan 1;12:Doc17.

IntroductionQuality improvement and safety in intensive care are rapidly evolving topics. However, there is no gold standard for assessing quality improvement in intensive care medicine yet. In 2007 a pilot project in German intensive care units (ICUs) started using voluntary peer reviews as an innovative tool for quality assessment and improvement. We describe the method of voluntary peer review and assessed its feasibility by evaluating anonymized peer review reports and analysed the thematic clusters highlighted in these reports.MethodsRetrospective data analysis from 22 anonymous reports of peer reviews. All ICUs - representing over 300 patient beds - had undergone voluntary peer review. Data were retrieved from reports of peers of the review teams and representatives of visited ICUs. Data were analysed with regard to number of topics addressed and results of assessment questionnaires. Reports of strengths, weaknesses, opportunities and threats (SWOT reports) of these ICUs are presented.ResultsExternal assessment of structure, process and outcome indicators revealed high percentages of adherence to predefined quality goals. In the SWOT reports 11 main thematic clusters were identified representative for common ICUs. 58.1% of mentioned topics covered personnel issues, team and communication issues as well as organisation and treatment standards. The most mentioned weaknesses were observed in the issues documentation/reporting, hygiene and ethics. We identified several unique patterns regarding quality in the ICU of which long-term personnel problems und lack of good reporting methods were most interesting Conclusion: Voluntary peer review could be established as a feasible and valuable tool for quality improvement. Peer reports addressed common areas of interest in intensive care medicine in more detail compared to other methods like measurement of quality indicators.

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