Quality Improvement in the Intensive Care Unit
Medical error is common and devastating, claiming the lives of an estimated 100,000 people per year in the USA. The intellectual origins of the modern intensive care unit (ICU) quality improvement (QI) movement can be traced to post-World War II Japanese industrial process management and to aviation safety. From Japanese Industrial process management, the concepts of unnecessary variation and statistical process control have been applied to the ICU to develop our current QI efforts. The Structure–Process–Outcome model of QI provides a solid theoretical approach for many efforts. From aviation safety, Human Factors Analysis, Checklists, and Crew Resource Management are tools adapted for the ICU QI team. The Institute for Healthcare Improvement has created a practical, stepwise QI process that uses a Plan-Do-Study-Act cycle to help QI teams assess and improve their ICUs. These tools provide a foundation for quality improvement efforts in the ICU.
KeywordsIntensive care unit Critical care Quality Quality improvement Medical error Variation Checklist Protocol
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