Development and implementation of a high-quality clinical database: the Australian and New Zealand intensive care society adult patient database

Objective: To describe the development of a binational intensive care database. Setting: One hundred thirty-eight intensive care units (ICUs) in Australia and New Zealand. Methods: A structure was developed to enable ICUs to submit data for central and local analysis. Reports were developed to allow comparison with similar ICU types and against published mortality prediction models. The database was evaluated according to (a) the criteria of the Directory of Clinical Databases (DoCDat) and (b) a proposed framework for data quality assurance in medical registries. Results: Between January 1987 and December 2003, 444 147 data sets were collected from 121 (72.5%) of 167 Australian and 10 (37.0%) of 27 New Zealand ICUs. Data sets from more than 60000 ICU admissions were submitted in 2003. Overall hospital mortality was 14.5%. The mean quality level achieved according to DoCDat criteria was high as was performance against a proposed framework for data quality. The provision of no-cost software has been vitally important to the success of the database. Conclusion: A high-quality ICU database has successfully been implemented in Australia and New Zealand and is now used as a routine quality assurance and peer review tool. Similar developments may be both possible and desirable in other countries. (C) 2006 Elsevier Inc. All rights reserved.