Introduction of JIPAD

Total number of ICUs/PICUs, n	95
Hospital type, n (%)
Municipal hospital	15 (15.8)
Public hospital	7 (7.4)
Public university hospital	18 (18.9)
National university hospital	21 (22.1)
National hospital	7 (7.4)
Private university hospital	14 (14.7)
Private hospital	13 (13.7)
Number of ICU beds*	11 [8, 16]
Number of annual ICU admissions*	690 [483, 905]
Number of annual pediatric admissions*	13 [2, 50]
Number of full-time ICU doctors*	3 [1, 4]
Number of board-certified intensivists*	3 [2, 6]
Number of full-time ICU nurses*	35 [30, 51]
ICU/PICUs with certified nurses in intensive care, n (%)	58 (61.1)
Proportion of ICU/PICUs with certified nurses in emergency nursing, n (%)	26 (27.4)
Proportion of ICU/PICUs with certified nurse specialists in critical care nursing, n (%)	31 (32.6)
Proportion of ICU/PICUs with dedicated ICU clinical engineers, n (%)	68 (71.6)
Proportion of ICU/PICUs with dedicated ICU pharmacists, n (%)	72 (75.8)

*Median [IQR]
Public hospitals include the Red Cross Hospital, Rosai Hospital, Saiseikai Hospital, Social Insurance Hospital, and Welfare Pension Hospital.

データ精度維持のための活動

Details: Published: 26 June 2018

Activities

Annual Reports: In addition to the static annual reports produced each year, dynamic reports including Exponentially Weighted Moving Average (EWMA) charts have been provided since the 2020 annual report.; As of August 2022, interactive facility-specific reports have also become available.

Collaboration with JICRG and the CTG Committee: Discussions with the Japanese Society of Intensive Care Medicine's CTG Committee began in 2017 to explore future collaborations. In 2020, the Japanese Intensive Care Research Group (JICRG), a board-direct organization, was established to oversee international collaborative research. JIPAD consults this body for international research and collaborates with the CTG Committee on new domestic multicenter studies.

Coordination with International Registries: In collaboration with Dr. Leo Celi from MIT and Dr. David Pilcher from ANZICS, efforts have been made to establish an international registry. The first datathon was held in February 2018, followed by a second in 2019, which can be viewed at the following URLs:
http://datathon-japan.jp/2018tokyo/index.html
http://datathon-japan.jp/2019/index.html; In 2021, with approval from JICRG, we joined the LOGIC (Linking of Global Intensive Care) international collaborative research and are currently considering participation in the Global Open Source Severity of Illness Score (GOSSIC-2) project.

Collaboration with the Pediatric Intensive Care Committee: Since April 2018, JIPAD has incorporated PIM3 and pediatric diagnoses, with pSOFA calculations available since August 2019. We aim to continue making minor updates to align with changes required by the Ministry of Health, Labour and Welfare.; The Pediatric Intensive Care Committee will continue to encourage PICUs nationwide to participate in JIPAD.

Addition and Modification of Data Collection Items: Support for JIPAD 2.0 ended on April 1, 2020.; Future considerations will include additional items required for calculating ANZROD, such as: Admission source (home, care facility, other hospital, other hospital ICU), Presence of treatment limitations upon ICU admission Reference for ANZROD: Paul E, et al. J Crit Care. 2013; 28: 935-41.; Development of ExJIPAD: Facilities can now freely set their own data collection items in addition to the basic items and output them in CSV format. This system can also be used as a patient registry. Further developments will continue to improve usability.; Adjustment and Addition of Disease Classifications: We will continue to update and refine the JIPAD dictionary to ensure it remains current.

Calculation of Predicted Mortality Rates: ANZICS and the UK's Intensive Care National Audit & Research Centre (ICNARC) have developed their own severity scores. JIPAD has established a mortality prediction model specific to Japan (Japanese Risk of Death; JROD), and since the 2020 annual report, predicted mortality rates calculated from JROD have been provided.

2022 Revision of Medical Service Fees: As of April 2022, an extension of the days eligible for additional specific intensive care management fees was approved, with participation in JIPAD being a requirement. For more details, please refer to the following link:
https://www.jsicm.org/research/jipadjoin/

Addressing Increased Workload: The number of participating facilities has nearly reached 100, with further growth expected. Similar challenges have been faced by other registry organizations like ANZICS following their establishment. We are currently exploring strategies to address this, considering collaboration with the NPO Intensive Care Collaboration Network.

データ精度維持のための活動

Details: Published: 26 June 2018

Data quality

Site Visits: Objectives
(1) To maintain the quality of data by understanding the specific conditions at each facility and providing tailored guidance to minimize the burden on staff.
(2) To directly gather feedback and address any system issues or concerns raised by the facilities.
(3) To establish personal connections ("face familiarity") to facilitate smoother communication in the future.; Specific activities
(1) Participating in morning rounds and conferences
(2) Observing the data entry systems in use and the actual data entry process.
(3) Offering suggestions related to the operation of JIPAD and responding to any questions that may arise.; Achievements
(1) Site visits commenced in March 2015.
(2) Although the visits became challenging due to the COVID-19 pandemic starting in 2020, as of December 2022, a total of 85 facilities have been visited.

The Query System: To minimize human error during the data collection process, we developed the following procedure based on interactions between participating ICU/PICUs and administrators (e.g., analysts):
(1) Participating facilities upload data for 10 cases at a time.
(2) The administrators review the data and provide feedback on any errors or issues identified.
(3) The participating facilities review the feedback, make necessary corrections, and re-upload the data.
(4) Based on the feedback, facilities proceed to enter the next set of 10 cases.
(5) This process continues until all 10 cases are free of errors, after which the facility can freely upload data.

Irregular Review: After the query system is completed, a random selection of 10 cases is reviewed every few months, and feedback is provided on any errors found.; This process helps maintain ongoing data accuracy.

Memo: Both ANZICS and ICNARC conduct data entry audits (for example, ICNARC, with sufficient resources, checks all cases by default).; In facilities where the query system is implemented,basic errors typically decrease significantly after trial entries of 50-60 cases. Repeating this process when primary data entry personnel change ensures data quality.; Although the query system was introduced to improve data accuracy,it has also helped identify not only human entry errors but also design flaws in the CSV output formats used by facilities.

データ精度維持のための活動

Details: Published: 26 June 2018

Growth

• The trend in the number of registered cases was tracked monthly starting from August 2015.
• As of December 31, 2023, 318 institutions have declared their participation, with 140 of them having commenced data registration.
• The number of institutions registering data has shown an increasing trend since 2016, and a similar increase is anticipated in the future.
• The number of registered cases reached 100,000 in May 2019, 200,000 in April 2021, 300,000 in September 2022, and 400,000 in October 2023.

Figure. The trend in the number of participating facilities and registered cases.

Institutions	Type of hospital	Number of ICU beds
ICU, University Hospital, Kyoto Prefectural University of Medicine	Public University	6
PICU, University Hospital, Kyoto Prefectural University of Medicine	Public University	6
Department of Intensive Care, The Jikei University Hospital	Private University	20
ICU, Tokyo Bay Urayasu Ichikawa Medical Center	Private	12
ICU, Department of Emergency and Critical Care Medicine, Keio University Hospital	Private University	16
Department of Emergency and Critical Care Medicine, Nara Medical University	Public University	14
Emergency and Critical Care Medicine, Tokushima University Hospital	National University	11
EICU, Kurashiki Central Hospital	Private	10
ICU, Kurashiki Central Hospital	Private	24
ICU, Hirosaki University Hospital	National University	16
Department of Emergency and Critical Care Medicine, Wakayama Medical University Hospital	Public University	10
ICU, Kumamoto Medical Center	National	6
ICU, Fujita Health University Hospital	Private University	18
ICU, Jichi Medical University Saitama Medical Center	Private University	30
ICU, The Jikei University Kashiwa Hospital	Private University	14
ICU, Suwa Red Cross Hospital	Municipal	8
ICU, Fukuyama City Hospital	Public	8
Critical Care and Emergency Center, Fukuyama City Hospital	Public	8
ICU, Yokohama City Minato Red Cross Hospital	Municipal	10
Department of Emergency Medicine and ICU, Dokkyo Medical University Hospital	Private University	12
E-ICU/CCU, St. Mary's Hospital	Private	12
ICU, St. Mary’s Hospital	Private	18
ICU/CCU Center, Chutoen General Medical Center	Public	10
ICU, JA Hiroshima General Hospital	Municipal	8
Advanced Critical Care Center, Gifu University Hospital	National University	6
ICU, Juntendo University Hospital	Private University	16
Central ICU, Kyorin University Hospital	Private University	18
Department of Critical Care Medicine, Sakai City Medical Center	Public	8
ICU, Osaka University Hospital	National University	29
ICU, Shin-Yurigaoka General Hospital	Private	10
Advanced ICU, Tottori University Hospital	National University	6
ICU, Jikei University School of Medicine Katsushika Medical Center	Private University	12
EICU, Kobe City Medical Center General Hospital	Public	8
GICU, Kobe City Medical Center General Hospital	Public	8
ICU, Osaka General Medical Center	National	10
CCU/ICU, Sendai Kousei Hospital	Private	18
Advanced Emergency and Critical Care Center, Hiroshima University Hospital	National University	10
ICU, Okinawa Prefectural Chubu Hospital	Municipal	12
Pediatric Intensive Care Unit, Shizuoka Children's Hospital	Municipal	12
Kagoshima University Hospital	National University	14
ICU, Takamatsu Red Cross Hospital	Public	4
Intensive Care Center, Shizuoka General Hospital	Public	14
EICU, Shiga University of Medical Science Hospital	National University	12
ICU, Saitama Medical University International Medical Center	Private University	14
Department of Intensive Care Medicine, Tokyo Medical and Dental University Hospital	National University	12
ICU, Oita University Hospital	National University	8
ICU, Gunma University Hospital	National University	17
ICU, Yamagata University Hospital	National University	6
Department of Anesthesia, Kyoto Medical Center	National	6
PICU, The Jikei University Hospital	Private University	6
PICU, Hyogo Prefectural Kobe Children's Hospital	Public	16
Surgical Intensive Care Unit, Nagoya University Hospital	National University	20
ICU, Chubu Tokushukai Hospital	Private	10
ICU, Kobe University Hospital	National University	20
ICU, Kagawa University Hospital	National University	6
ICU, Hamamatsu University Hospital	National University	12
ICU, St. Marianna University School of Medicine Hospital	Private University	30
ICU, Japanese Red Cross Saitama Hospital	Municipal	8
Department of Emergency and Critical Care Medicine, Nara Medical University	Public University	10
Critical Care and Emergency Center, Tokyo Medical Center	National	6
ICU, Iizuka Hospital	Private	12
ICU, St. Luke's International Hospital	Private University	8
ICU, Kanazawa University Hospital	National University	22
ICU, Omihachiman City Medical Center	Public	6
Department of Anesthesiology and ICU, Ichinomiya Nishi Hospital	Private	8
Critical Care and Emergency Center, Asahikawa Red Cross Hospital	Municipal	6
ICU, Matsue Red Cross Hospital	Municipal	13
Critical Care and Emergency Center, Osaka National Hospital	National	26
ICU, Sakakibara Heart Institute	Private	16
Critical Care and Emergency Center, Saiseikai Yokohama City Tobu Hospital	Municipal	10
Department of Emergency and Critical Care, University of Tsukuba Hospital	National University	20
ICU, Kyoto University Hospital	National University	20
GICU, Hyogo Prefectural Amagasaki General Medical Center	Public	12
ICU, Mie University Hospital	National University	14
ICU, Japanese Red Cross Medical Center	Municipal	14
ICU, Chiba Children’s Hospital	Public	9
ICU, Tohoku University Hospital	National University	18
Department of Anesthesiology and ICU, Funabashi Municipal Medical Center	Public	8
ICU, Tokyo Metropolitan Bokutoh Hospital	Public	8
Department of Emergency and Critical Care, Juntendo University Nerima Hospital	Private University	12
ICU, Toranomon Hospital	Municipal	20
Pediatric ICU, Matsudo City General Medical Center	Public	8
Critical Care and Emergency Center, Matsudo City General Medical Center	Public	16
Critical Care and Emergency Center, Osaka General Medical Center	Municipal	16
ICU, Fukushima Medical University	Public University	8
ICU, Yokohama City University Hospital	Public University	8
ICU, Gifu Prefectural General Medical Center	Public	8
Department of Emergency Medicine, University of Yamanashi Hospital	National University	12
Emergency and Medical Intensive Care Unit, Nagoya University Hospital	National University	8
General ICU, Tokyo Saiseikai Central Hospital	Public	10
Critical Care and Emergency Center, Tokyo Saiseikai Central Hospital	Public	10
ICU, Suita Tokushukai Hospital	Private	10
ICU, Maebashi Red Cross Hospital	Municipal	18
Critical Care and Emergency Center, Ureshino Medical Center	Public	8
ICU, Yao Tokushukai General Hospital	Private	8

データ精度維持のための活動

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