Improving the ICU : Part 2

ICUs are a vital but troubled component of modern health-care systems. Improving ICU performance requires that we shift from a paradigm that concentrates on individual performance, to a systems-oriented approach that emphasizes the need to assess and improve the ICU systems and processes that hinder the ability of individuals to perform their jobs well. This second part of a two-part treatise establishes a practical framework for performance improvement and examines specific strategies to improve ICU performance, including the use of information systems.Learning Objectives1. Improving ICU performance involves sequential steps of: (1) measuring relevant indices of ICU performance, (2) making interventions aimed at improving those measures, and then (3) remeasuring the indices to document the effect of the intervention 2. Every ICU should have a systems-oriented Performance Improvement Program that is multidisciplinary and inclusive and has the support of the hospital and ICU leadership needed to succeed if ICU performance is to improve.