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Quality Assurance and Improvement in the Intensive Care Unit

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Oncologic Critical Care

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Abstract

Quality of care is defined as care which produces the greatest expected improvement in health status. Major strides towards quality and safety initiatives were made after the Institute of Medicine published the report: To Err Is Human, in 2000. Although innumerous quality and safety initiatives have been implemented and some improvements in health care delivery and outcomes have been demonstrated, gaps still exist. This chapter will describe methods and conceptual frameworks used to improve processes and outcomes in the care of critically ill patients. Agencies involved in evaluating quality and offering assistance to health care providers, institutions, and systems will also be discussed. Finally, performance measures specific to the intensive care unit will be outlined.

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References

  1. Aspden P, Wolcott JA, Bootman JL, et al., editors. Preventing medication errors. Washington, DC. 2007. https://psnet.ahrq.gov/resources/resource/4053/preventing-medication-errors-quality-chasm-series--

  2. Baily MA, Bottrell M, Lynn J, et al. The ethics of using QI methods to improve health care quality and safety. Hastings Cent Rep. 2006;36(4):S1.

    Article  Google Scholar 

  3. Churpek MM, Hall JB. Measuring and rewarding quality in the ICU: the yardstick is not as straight as we wish. Am J Respir Crit Care Med. 2012;185(1):3. https://doi.org/10.1164/rccm.201110-1813ED.

    Article  PubMed  Google Scholar 

  4. Commission on Cancer®. 2018. https://www.facs.org/quality-programs/cancer/coc

  5. Critical Care Societies Collaborative (CCSC). NQF measures. 2018. http://ccsconline.org/high-value-care/nqf-measures

  6. Davidoff F, Batalden PB, Stevens DP, et al. Development of the SQUIRE Publication Guidelines: evolution of the SQUIRE project. BMJ Qual Saf. 2008;34: 681–7.

    Google Scholar 

  7. Deming WE. Out of the crisis. Cambridge, Mass: Massachusetts Institute of Technology, Center for Advanced Engineering Study, 1986.

    Google Scholar 

  8. Deming WE. The new economics for industry, government & education. Cambridge, MA: Massachusetts Institute of Technology, Center for Advanced Engineering Study, 1994.

    Google Scholar 

  9. Donabedian A. The quality of care: how can it be assessed? JAMA. 1988;260(12):1743–8. https://doi.org/10.1001/jama.260.12.1743.

    Article  CAS  PubMed  Google Scholar 

  10. Evans SM, Berry JG, Smith BJ, et al. Attitudes and barriers to incident reporting: a collaborative hospital study. Qual Saf Health Care. 2006;15(1):39–43. https://doi.org/10.1136/qshc.2004.012559.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Halpern SD, Becker D, Curtis JR, et al. An official American Thoracic Society/American Association of Critical-Care Nurses/American College of Chest Physicians/Society of Critical Care Medicine policy statement: the Choosing Wisely® top 5 list in critical care medicine. Am J Respir Crit Care Med. 2014; 190(7):818–26. https://doi.org/10.1164/rccm.201407-1317ST.

    Article  PubMed  Google Scholar 

  12. HealthGrades. 2018. http://www.healthgrades.com/

  13. Hewitt M, Simone JV, editors. Ensuring quality cancer care. Washington, DC: Institute of Medicine National Research Council, National Academy Press; 1999.

    Google Scholar 

  14. Holm M, Selvan M, Smith M, et al. Quality improvement or research: defining and supervising QI at the University of Texas M.D. Anderson Cancer Center. In: Jennings B, et al., editors. Health Care Quality Improvement: ethical and regulatory issues. New York: The Hastings Center; 2006. p. 145–69.

    Google Scholar 

  15. Imai M. Kaizen (Ky’Zen), the key to Japan’s competitive success. New York: Random House Business Division, 1986.

    Google Scholar 

  16. Institute for Healthcare Improvement. How to improve. 2018. http://www.ihi.org/IHI/Topics/Improvement/ImprovementMethods/HowToImprove

  17. Kohn LT, Corrigan J, Donaldson MS. To err is humans: Building a safe health system. Washington, DC, National Academy Press; 2000.

    Google Scholar 

  18. Ishikawa K. What is total quality control? The Japanese way. Englewood Cliffs, N.J.: Prentice-Hall, 1985.

    Google Scholar 

  19. Kopp BJ, Erstad BL, Allen ME, et al. Medication errors and adverse drug events in an intensive care unit: direct observation approach for detection. Crit Care Med. 2006;34(2):415–25.

    Article  Google Scholar 

  20. Langley GJ, Nolan KM, Nolan TW, et al. The improvement guide: a practical approach to enhancing organizational performance. San Francisco, CA: Jossey-Bass Publishers, 2009.

    Google Scholar 

  21. Lean Enterprise Institute. What is Lean? 2018. https://www.lean.org/WhatsLean/

  22. Institute of Medicine (U.S.). Division of Health Care Services, Lohr KN, United States. Health Care Financing Administration, Institute of Medicine (U.S.). Committee to Design a Strategy for Quality Review and Assurance in Medicare. Medicare: a strategy for quality assurance. Washington, DC: National Academy Press; 1990.

    Google Scholar 

  23. MacFie CC, Baudouin SV, Messer PB. An integrative review of drug errors in critical care. JICS. 2015; 17(1):63–72.

    PubMed  Google Scholar 

  24. Mendelson A, Kondo K, Damberg C, et al. The effects of pay-for-performance programs on health, health care use, and processes of care: a systematic review. Ann Intern Med. 2017;166(5):341–53. https://doi.org/10.7326/M16-1881.

    Article  PubMed  Google Scholar 

  25. Mick JM, Wood GL, Massey RL. The good catch pilot program: increasing potential error reporting. J Nurs Adm. 2007;37(11):499–503.

    Article  Google Scholar 

  26. Munro RA, Ramu G, Zyrmiac DJ. The certified six sigma green belt handbook, 2nd ed., Milwaukee, Wisconsin: ASQ Quality Press, 2015.

    Google Scholar 

  27. Murphy DJ, Ogbu OC, Coopersmith CM. ICU director data using data to assess value, inform local change, and relate to the external world. Chest. 2015;147(4): 1168–78.

    Article  Google Scholar 

  28. National Patient Safety Foundation. Free from harm: accelerating patient safety improvement fifteen years after to err is human. Boston, MA: National Patient Safety Foundation, 2015.

    Google Scholar 

  29. National Quality Forum (NQF). Pulmonary and critical care 2015–2016 technical report. 2016. Accessed 24 July 2018. http://www.qualityforum.org/Publications/2016/10/Pulmonary_and_Critical_Care_2015-2016_Final_Report.aspx

  30. Newhouse RP, Pettit JC, Poe S, et al. The slippery slope: differentiating between quality improvement and research. JONA. 2006;36(4):211–9.

    Article  Google Scholar 

  31. Ogrinc G, Davies L, Goodman D, et al. SQUIRE 2.0 (Standards for Quality Improvement Reporting Excellence): revised publication guidelines from a detailed consensus process. BMJ Qual Saf. 2015;0:1–7. https://doi.org/10.1136/bmjqs-2015-004411.

    Article  Google Scholar 

  32. Rothschild JP, Landrigan CP, Cronin JW, et al. The critical care safety study: the incidence and nature of adverse events and serious medical errors in intensive care. Crit Care Med. 2005;33(8):1694–700.

    Article  Google Scholar 

  33. Rutledge DN, Retrosi T, Ostrowski G. Barriers to medication error reporting among hospital nurses. J Clin Nurs. 2018;27:1941–9. https://doi.org/10.1111/jocn.14335.

    Article  PubMed  Google Scholar 

  34. Sackett DL, Rosenberg WMC, Gray JA, et al. Evidence based medicine: what it is and what it isn’t. BMJ. 1996;312:7023.

    Google Scholar 

  35. Shewhart WA Deming WE. Statistical method from the viewpoint of quality control. Washington: The Graduate School, The Dept. of Agriculture, 1939.

    Google Scholar 

  36. The Joint Commission. 2018 Hospital national patient safety goals. 2018a. https://www.jointcommission.org/assets/1/6/2018_HAP_NPSG_goals_final.pdf

  37. The Joint Commission. Measures. 2018b. https://www.jointcommission.org/core_measure_sets.aspx

  38. The Leapfrog Group. The Leapfrog hospital safety grade. 2018. http://www.leapfroggroup.org/cp

  39. Timmers TK, Verhofstad MHJ, Moons KGM, et al. Intensive care performance: how should we monitor performance in the future? World J Crit Care Med. 2014;3(4):74–9.

    Article  Google Scholar 

  40. U.S. Department of Health and Human Service. Hospital compare. 2018. https://www.medicare.gov/hospitalcompare/search.html

  41. U.S. News and World Reports. Health hospitals. 2018. http://health.usnews.com/best-hospitals

  42. Valiani S, Rigal R, Stelfox HT, et al. An environmental scan of quality indicators in critical care. CMAJ Open. 2017;5(2):E488–95. https://doi.org/10.9778/cmajo.20150139.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Wang T, Benedict N, Olsen KM. Effect of critical care pharmacist’s intervention on medication errors: a systematic review and meta-analysis of observational studies. J Crit Care. 2015;30(5):1101–6.

    Article  CAS  Google Scholar 

  44. Weiser T, Haynes A, Lashoher A, et al. Perspectives in quality: designing the WHO surgical safety checklist. Int J Qual Health Care. 2010;22:365–70. https://doi.org/10.1093/intqhc/mzq039.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Critical Care, UT MD Anderson Cancer Center, Houston, TX, USA

    Mary Lou Warren

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  1. Mary Lou Warren
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Correspondence to Mary Lou Warren .

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Editors and Affiliations

  1. Department of Critical Care, University of Texas MD Anderson Cancer C Department of Critical Care, Houston, TX, USA

    Joseph L. Nates

  2. Department of Critical Care, University of Texas MD Anderson Cancer C Department of Critical Care, Houston, TX, USA

    Kristen J. Price

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Warren, M.L. (2019). Quality Assurance and Improvement in the Intensive Care Unit. In: Nates, J., Price, K. (eds) Oncologic Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-319-74698-2_4-1

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  • DOI: https://doi.org/10.1007/978-3-319-74698-2_4-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-74698-2

  • Online ISBN: 978-3-319-74698-2

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