Establishing a critical care network in Asia to improve care for critically ill patients in low- and middle-income countries

Beane, Abi; Dondorp, Arjen M.; Taqi, Arshad; Asma., Ahsan; Bkt, Vijayaraghavan; Permpikul, Chairat; Pell, Christopher; Gandy, D; Priyadarshani, Dilanthi; Aryal, Diptesh; Khiem, Dong Phu; Thuy, Duong Bich; Thwaites, Guy; Kayastha, Gyan; Udayanga, Ishara; Salluh, Jorge I.; Detleuxay, Khamsay; Ranganathan, Lakshmi Narasimhan; Yen, Lam Minh; Har, Lim Chiew; Thwaites, Louise; Hashmi, Madiha; Schultz, Marcus J.; Mukaka, Mavuto; Leaver, Meghan; Mbm., Nor; Hayat, Muhammad; Day, Nick; Moonesinghe, Ramani; Haniffa, Rashan; Champunot, Ratapum; Inglis, Rebecca; Sultana, Rozina; Yacoub, Sophie; Harris, Steve; Acharya, Subhash Prasad; Tripathy, Swagata; Ali, Syed; Kadhiravan, Tamilarasu; Lubell, Yoel

doi:10.1186/s13054-020-03321-7

Cited by 33 publications

(21 citation statements)

References 14 publications

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“…Critical care registry projects including “Collaboration for Research, Implementation and Training in Asia and Africa (CCAA)” “Global Open Source Severity of Illness Score”and a study looking at organisational characteristics, outcomes and resource utilisation in Brazil have demonstrated the potential in using large scale registry databases to use data as a driver of quality improvement. [ 40 , 41 , 47 , 48 ,]. Currently the National Institute of Health, Duke Clinical Research Institute and the Pew Charitable Trust are investing in registry data standards for concepts in registries.…”

Section: How Intensive Care Registries Can Improve Implementation and Interpretation Of Icu Outcomesmentioning

confidence: 99%

“…Perhaps the most comprehensive and current effort towards achieving this is Linking of Global Intensive Care (LOGIC). [ 46 , 47 , 48 ] A collaboration of registries from 13 countries, it includes aggregate data on over seven million ICU encounters from Asia, Australasia, Europe, North America and South America. Its aim is to promote data sharing and international benchmarking through pragmatic reporting of crude aggregated national data from registries.…”

Section: How Intensive Care Registries Can Improve Implementation and Interpretation Of Icu Outcomesmentioning

confidence: 99%

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What intensive care registries can teach us about outcomes

Beane

Salluh

2021

Current Opinion in Critical Care

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Purpose of review Critical care registries are synonymous with measurement of outcomes following critical illness. Their ability to provide longitudinal data to enable benchmarking of outcomes for comparison within units over time, and between units, both regionally and nationally is a key part of the evaluation of quality of care and ICU performance as well as a better understanding of case-mix. This review aims to summarise literature on outcome measures currently being reported in registries internationally, describe the current strengths and challenges with interpreting existing outcomes and highlight areas where registries may help improve implementation and interpretation of both existing and new outcome measures. Recent findings Outcomes being widely reported through ICU registries include measures of survival, events of interest, patient reported outcomes and measures of resource utilisation (including cost). Despite its increasing adoption, challenges with quality of reporting of outcomes measures remain. Measures of short-term survival are feasible, but those requiring longer follow-ups are increasingly difficult to interpret given the evolving nature of critical care in the context of acute and chronic disease management. Furthermore, heterogeneity in patient populations and in healthcare organisations in different settings makes use of outcome measures for international benchmarking at best complex, requiring substantial advances in their definitions and implementation to support those seeking to improve patient care. Summary Digital registries could help overcome some of the current challenges with implementing and interpreting ICU outcome data through standardisation of reporting and harmonisation of data. In addition, ICU registries could be instrumental in enabling data for feedback as part of improvement in both patient centred outcomes and in service outcomes; notably resource utilisation and efficiency.

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Section: How Intensive Care Registries Can Improve Implementation and Interpretation Of Icu Outcomesmentioning

confidence: 99%

Section: How Intensive Care Registries Can Improve Implementation and Interpretation Of Icu Outcomesmentioning

confidence: 99%

What intensive care registries can teach us about outcomes

Beane

Salluh

2021

Current Opinion in Critical Care

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“…No incentives were offered. The study was endorsed by professional bodies: Indian Registry of Intensive Care, 12 a member of Crit Care Asia, 13 the Indian Society of Critical Care Medicine, 14 the official critical care body of India, and the Critical Care Nurses Society. 15…”

Section: Aterials and M Ethodsmentioning

confidence: 99%

Collateral Impact of the COVID-19 Pandemic on Acute Care of Non-COVID Patients: An Internet-based Survey of Critical Care and Emergency Personnel

Tripathy

Vijayaraghavan

Panigrahi

et al. 2021

Indian Journal of Critical Care Medicine

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A bstract Purpose The impact of disruption to the care of non-coronavirus disease (COVID) patients (COVID collateral damage syndrome-CCDS) is largely unknown in resource-limited settings. We investigated CCDS as perceived by healthcare workers (HCWs) providing acute and critical care services in India. Materials and methods A clinician and nurse codesigned and validated an internet-based survey, which was disseminated to HCWs using a multiple frame sampling technique. Results Responses were received from 468 HCWs (completion rate 84%); at the time of the survey, 48% were working in critical care, 41% aged 30–40 years, and 53% represented public institutions. Respondents perceived a decrease in service utilization and disruption to time-sensitive acute interventions (60.1% and 40.8%, respectively), with fear of infection (score, 63.0; standard deviation (SD), 31.8) and restrictions due to lockdown (61.4; SD 32.5) being cited as the causes of service disruption. Being overwhelmed or lack of protective equipment was perceived to contribute less to CCDS. Insistence on COVID test results X 2 ( p = 0.02) and duty-avoidance ( p < 0.01) was perceived as significant causes for CCDS by HCWs from private hospitals and those in leadership roles, respectively. Conclusions Fear of infection and the effect of lockdown were perceived as important contributors to CCDS resulting in disruption to services and decreased service utilization. Perceptions were influenced by HCWs’ role and hospital organizational structure. How to cite this article Tripathy S, Vijayaraghavan BKT, Panigrahi MK, Shetty AP, Haniffa R, Mishra RC, et al . Collateral Impact of the COVID-19 Pandemic on Acute Care of Non-COVID Patients: An Internet-based Survey of Critical Care and Emergency Personnel. Indian J Crit Care Med 2021;25(4):374–381.

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“…Wellcome - Mahidol Oxford Tropical Medicine Research Unit supported CCA is a LMIC-led collaborative spanning nine Asian countries 5 . Its goal is to improve outcomes for critically ill patients, using near real-time high-quality data captured through a cloud-based registry platform to enable setting prioritised improvement, training and research.…”

Section: Introductionmentioning

confidence: 99%

Operationalisation of the Randomized Embedded Multifactorial Adaptive Platform for COVID-19 trials in a low and lower-middle income critical care learning health system.

Aryal¹,

Beane

Dondorp

et al. 2021

Wellcome Open Res

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The Randomized Embedded Multifactorial Adaptive Platform (REMAP-CAP) adapted for COVID-19) trial is a global adaptive platform trial of hospitalised patients with COVID-19. We describe implementation in three countries under the umbrella of the Wellcome supported Low and Middle Income Country (LMIC) critical care network: Collaboration for Research, Implementation and Training in Asia (CCA). The collaboration sought to overcome known barriers to multi centre-clinical trials in resource-limited settings. Methods described focused on six aspects of implementation: i, Strengthening an existing community of practice; ii, Remote study site recruitment, training and support; iii, Harmonising the REMAP CAP- COVID trial with existing care processes; iv, Embedding REMAP CAP- COVID case report form into the existing CCA registry platform, v, Context specific adaptation and data management; vi, Alignment with existing pandemic and critical care research in the CCA. Methods described here may enable other LMIC sites to participate as equal partners in international critical care trials of urgent public health importance, both during this pandemic and beyond.

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Establishing a critical care network in Asia to improve care for critically ill patients in low- and middle-income countries

Cited by 33 publications

References 14 publications

What intensive care registries can teach us about outcomes

What intensive care registries can teach us about outcomes

Collateral Impact of the COVID-19 Pandemic on Acute Care of Non-COVID Patients: An Internet-based Survey of Critical Care and Emergency Personnel

Operationalisation of the Randomized Embedded Multifactorial Adaptive Platform for COVID-19 trials in a low and lower-middle income critical care learning health system.

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