Protocol Development and Quality Improvement
ICU and hospital LOS
Impact on mortality or morbidity
Impact on disease identification, disease prevalence, or clinical outcome
Evaluation of infectious diseases within the ICU
Cost of care versus diagnosis-related group (DRG) reimbursement
Duration of mechanical ventilation
Medication management procedures need to be continuously monitored and improved because of their
complexity.
Medication safety – Adverse drug events prevented, time since event reached a patient, etc.
The Institute of Medicine – Chartered in 1970. Published reports titled “The Urgent Need to Improve
Health Care Quality,” “Crossing the Quality Chasm,” “To Err Is Human”
100,000 Lives Campaign, 5 Million Lives Campaign (December 12, 2006 – December 9, 2008)
No needless list
No needless deaths
ii.
No needless pain or suffering
iii.
No helplessness in those served or serving
iv.
No unwanted waiting
No waste
vi.
No one left out
Critical care initiatives
Acute myocardial infarction
ii.
Catheter-associated urinary tract infections
iii.
Central line–associated bloodstream infections
iv.
Health care–associated infections
Sepsis detection and initial management
vi.
Medication reconciliation to prevent ADEs
vii.
Pain, agitation/sedation, delirium, immobility, and sleep (PADIS) (i.e., the ABCDEF bundle)
viii.
Surgical site infections
ix.
Ventilator-associated pneumonia
Rapid response teams
xi.
High-alert medication safety
xii.
Pressure ulcer care
| d. | The seven rights of medication administration: Right patient, right medication, right dose, right |
|---|
time, right route, right reason, right documentation.
Ask “Why” five times to get to the root cause - key to solving a problem
National Quality Forum – Created in 1999
More than 300 measures, indicators, events, practices, and other products to help assess quality.
Has been endorsed to become the gold standard of measuring health care quality