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Five years have passed since we published the first edition of this dictionary. During this time, the Japan ICU Patient Database (JIPAD) has grown steadily with your support. I would like to express my gratitude to all of you for your cooperation. A lot has really happened in the past five years. For more details, please refer to our 2016 Annual Report published in February 2018. This is our second annual report, which is a tour de force. This was made possible by the JIPAD Working Group, a sub-organization of the ICU Functional Evaluation Committee, which was established last year. At the same time, we were also able to obtain a database project grant from the Ministry of Health, Labour and Welfare to begin full-scale operations. Furthermore, in order to respond to the revision of reimbursement in April 2018, SOFA was added as a severity evaluation item, and as a result of consultation with the PICU Committee, we are now developing JIPAD3.0, which includes functions such as the adoption of PIM3 as the severity of pediatric patients. The new JIPAD3.0 has enhanced alert functions, and has user-friendly features such as ExJIPAD, which is designed to be used as a ledger function, so we hope you will adopt it. The dictionary has been revised from version 1.3 to 3.0 at once, and we have created adult and pediatric disease name codes that can be used as a global standard while keeping up with the current situation in Japan.　 Currently, more than 50 facilities have already registered their cases in JIPAD, and there are more than 800 intensive care facilities in Japan. Our immediate goal is to have all of the training facilities accredited by the Japanese Society of Intensive Care Medicine (JSIC), which as of 2018 has more than 300 and is still growing, join the registry. The purpose of establishing JIPAD is to improve clinical research in this field, and we expect that this will enable us to improve the quality of management of critically ill patients and to allocate medical resources appropriately in Japan. I would like to ask for your further cooperation in achieving this goal.

Satoru Hashimoto MD
March 1, 2018 Leader, JIPAD Working Group, ICU Functional Assessment Committee, Japanese Society of Intensive Care Medicine

The number of medical institutions in Japan that meet the standards for dedicated structures, facilities, and staffing appropriate for intensive care management (the number of institutions that can calculate the specific intensive care management fee) was 822 in 2010, an increase of more than 150 institutions over the past six years. The number of beds in each intensive care unit averages about 8 beds per facility, with 1/3 of the facilities having 6-7 beds (according to Ministry of Health, Labor and Welfare statistics, 2011). Furthermore, there are probably many other ICUs that do not calculate the specified intensive care unit management fee. If the medical care system in these critical care facilities is left unchecked, the overall medical care results will decline, leading to a worsening of the prognosis of critically ill patients and an increase in unnecessary medical care costs. The problem is that the medical treatment process and patient information related to medical treatment are not standardized as individual records, and in addition, the evaluation of medical treatment functions from the viewpoint of prognosis is not conducted, and these are not reflected in the reimbursement. As a means to solve the above problems, the Japanese Society of Intensive Care Medicine has developed a multicenter registration system for patients admitted to and managed in ICUs in Japan, which has been in operation since January 2014. This system will provide an objective evaluation of intensive care in Japan, objective indicators of differences between participating institutions (e.g., comparison of patient severity and mortality rates), and appropriate benchmarks. These measures are expected to improve treatment outcomes at each facility. In this system, the ANZICS-CORE (Australian and New Zealand Intensive Care Society, Centre for Outcome and Resource Evaluation) in Australia and New Zealand and the ICNARC (Intensive Care Nursing and Rehabilitation Centre) in the United Kingdom will be used. We would like to follow the lead of ANZICS-CORE (Australian and New Zealand Intensive Care Society, Centre for Outcome and Resource Evaluation) in Australia and New Zealand and ICNARC (Intensive Care National Audit and Research Centre) in the UK, and aim to establish a flexible system that can be used as the basic data for large-scale clinical trials.

Satoru Hashimoto MD
December 1, 2013 Chair, ICU Functional Assessment Committee, Japanese Society of Intensive Care Medicine