Technology-enabled performance monitoring in intensive care: An integrative literature review

Background: Implementation of evidence-based bundles in intensive care units is integral to improving quality of care and patient outcomes. However, it increases the burden of data collection and analysis required for performance monitoring and feedback of an inter-disciplinary care team. Health information technology including electronic health records and data analytic tools could automate this process and provide real-time feedback to the team. Aim: This integrative literature review aimed to examine the extent to which technology-enabled performance monitoring and feedback contributed to improving quality of care and patient outcomes when implementing evidence-based bundles. Methods: A literature search of scientific databases was conducted using PubMed, Embase, Scopus, CINHAL and Ovid Medline. Results: Of nine studies included in this review, all reported improved compliance of the team with evidence-based bundles, ranging from 3% to 60% post implementation of technology-enabled performance monitoring and feedback. Significant reductions (p < .05) in hospital acquired infections were also reported in five studies. Conclusions: Overall, the addition of documentation fields to electronic health records was essential in providing real-time feedback to teams and improving their compliance with evidence-based bundles. Further research is needed to assess the effectiveness of technology-enabled performance monitoring and feedback in improving patient outcomes on a larger scale, especially in resource-limited settings such as community hospitals. (C) 2018 Elsevier Ltd. All rights reserved.