Intensive care unit quality improvement: A “how-to” guide for the interdisciplinary team*

Curtis, J. Randall; Cook, Deborah J.; Wall, Richard J.; Angus, Derek C.; Bion, Julian; Kacmarek, Robert M.; Kane‐Gill, Sandra L.; Kirchhoff, Karin T.; Levy, Mitchell M.; Mitchell, Pamela H.; Moreno, Rui P.; Pronovost, Peter J.; Puntillo, Kathleen

doi:10.1097/01.ccm.0000190617.76104.ac

Cited by 331 publications

(194 citation statements)

References 37 publications

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“…Dentro de ellas, resalta la educación del personal de salud 10 y la introducción de nuevas técnicas de monitoreo y retroalimentación de la información. [11][12][13] Durante 2008-2009, en las UCIP del Hospital Garrahan, la incidencia de IAC oscilaba entre 9 y 12 por cada 1000 días de uso de catéter venoso central (CVC).…”

Section: Introductionunclassified

Impacto de un programa de reducción de infección asociada a catéter en 9 unidades de cuidado intensivo pediátrico en Argentina

2018

Arch Argent Pediatr

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Section: Introductionunclassified

Impacto de un programa de reducción de infección asociada a catéter en 9 unidades de cuidado intensivo pediátrico en Argentina

2018

Arch Argent Pediatr

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“…67 Important structure and process metrics are closely associated with important outcomes (eg, morbidity, mortality, cost). Selected structure or process measures should be strongly linked to important outcomes.…”

Section: Select An Appropriate Metricmentioning

confidence: 99%

ICU Director Data

Murphy¹,

Ogbu²,

Coopersmith

2015

Chest

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Improving value within critical care remains a priority because it represents a signifi cant portion of health-care spending, faces high rates of adverse events, and inconsistently delivers evidence-based practices. ICU directors are increasingly required to understand all aspects of the value provided by their units to inform local improvement eff orts and relate eff ectively to external parties. A clear understanding of the overall process of measuring quality and value as well as the strengths, limitations, and potential application of individual metrics is critical to supporting this charge. In this review, we provide a conceptual framework for understanding value metrics, describe an approach to developing a value measurement program, and summarize common metrics to characterize ICU value. We fi rst summarize how ICU value can be represented as a function of outcomes and costs. We expand this equation and relate it to both the classic structure-process-outcome framework for quality assessment and the Institute of Medicine's six aims of health care. We then describe how ICU leaders can develop their own value measurement process by identifying target areas, selecting appropriate measures, acquiring the necessary data, analyzing the data, and disseminating the fi ndings. Within this measurement process, we summarize common metrics that can be used to characterize ICU value. As health care, in general, and critical care, in particular, changes and data become more available, it is increasingly important for ICU leaders to understand how to eff ectively acquire, evaluate, and apply data to improve the value of care provided to patients.

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“…15,16 However, the 105 effectiveness of this approach has not been evaluated for improving sedation-analgesia 106 quality. Although several bedside sedation-monitoring technologies exist, these have not 107 previously been evaluated in large ICU effectiveness trials.…”

mentioning

confidence: 99%

Staff education, regular sedation and analgesia quality feedback, and a sedation monitoring technology for improving sedation and analgesia quality for critically ill, mechanically ventilated patients: a cluster randomised trial

Walsh

Kydonaki

Antonelli

et al. 2016

The Lancet Respiratory Medicine

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Walsh, T. S. et al. (2016) Staff education, regular sedation and analgesia quality feedback, and a sedation monitoring technology for improving sedation and analgesia quality for critically ill, mechanically ventilated patients: a cluster randomised trial. Lancet Respiratory Medicine, 4(10), pp. 807-817. (doi:10.1016/S2213-2600(16)30178-3) This is the author's final accepted version.There may be differences between this version and the published version. You are advised to consult the publisher's version if you wish to cite from it.

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Intensive care unit quality improvement: A “how-to” guide for the interdisciplinary team*

Cited by 331 publications

References 37 publications

Impacto de un programa de reducción de infección asociada a catéter en 9 unidades de cuidado intensivo pediátrico en Argentina

Impacto de un programa de reducción de infección asociada a catéter en 9 unidades de cuidado intensivo pediátrico en Argentina

ICU Director Data

Staff education, regular sedation and analgesia quality feedback, and a sedation monitoring technology for improving sedation and analgesia quality for critically ill, mechanically ventilated patients: a cluster randomised trial

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