Quality Management In Intensive Care

One of the first comprehensive summaries of the latest thinking and research in improving intensive care quality and patient safety.

This authoritative reference published under the auspices of the American Society of Critical Care Anesthesiologists (ASCCA) is now in its Second Edition. More than 100 internationally recognized experts present state-of-the-art strategies for successful, cost-effective perioperative care and management of acutely ill patients.This thoroughly revised edition features many distinguished new contributors from anesthesiology, critical care medicine, internal medicine, surgery, and pediatrics. Timely new chapters cover medical informatics, evidence-based medicine, human genomics, research in critical care medicine, and imaging in the ICU. Chapters on acute respiratory distress syndrome, sepsis, and other diseases have been rewritten to reflect recent technological and therapeutic breakthroughs.

The global trend of increasingly ageing societies and long term illnesses has meant a growth in demand for intensive care resources. This book advises on leadership and organizational development of intensive care units, in order to give best practices for governance, performance, emergency response and safety. Written by international experts in the field, each chapter allows researchers, clinicians and service providers worldwide to be able to refer to this single reference book. In seven parts, the volume will tackle aspects of intensive care management in both global and local contexts, and interrogate the key concerns that service providers face. It works as an informative guide for the practical administration of intensive care, as well as being international in its design and information.

Measuring the quality of a complex service like critical care that combines the highest technology with the most intimate caring is a challenge. Recently, con sumers, clinicians, and payers have requested more formal assessments and comparisons of the quality and costs of medical care [2). Donabedian [1) pro posed a framework for thinking about the quality of medical care that separates quality into three components: structure, process, and outcome. An instructive analogy for understanding this framework is to imagine a food critic evaluating the quality of a restaurant. The critic might comment on the decoration and lighting ofthe restaurant, how close the tables are to each other, the extent ofthe wine list and where the chef trained. These are all evaluations of the restaurant structure. In addition, the critic might comment on whether the service was courteous and timely - measures of process. Finally, the critic might comment on outcomes like customer satisfaction or food poisoning. Similarly, to a health care critic, structure is the physical and human resources used to deliver medi cal care. Processes are the actual treatments offered to patients. Finally,outcomes are what happens to patients, for example, mortality, quality of life,and satisfac tion with care (Table 1). There is a debate about which of these measurements is the most important measure of quality.

This new comprehensive resource Medical Quality Management: Theory and Practice addresses the needs of physicians, medical students, and other health care professionals for up to date information about medical quality management. In reviewing the key principles and methods that comprise the current state of medical quality management in U.S. health care, this text provides a concise summary of quality improvement, patient safety and quality measurement methodologies. Important Notice: The digital edition of this book is missing some of the images or content found in the physical edition.

Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.

This book provides a state-of-the-art overview on critical care administration. The text reviews important aspects and considerations involved in developing an efficient, cost-effective critical care program, while maintaining a safe and high-quality work environment. Major topics covered include different models of critical care services, planning and budgeting, administration support, staffing models, tele/smart ICU, protocols and guidelines, and disaster preparedness and management. Written by experts in the field, Critical Care Administration: A Comprehensive Clinical Guide is a practical, handy resource for critical care professionals involved in the administration and management of ICUs.

Measuring the quality of a complex service like critical care that combines the highest technology with the most intimate caring is a challenge. Recently, con sumers, clinicians, and payers have requested more formal assessments and comparisons of the quality and costs of medical care [2). Donabedian [1) pro posed a framework for thinking about the quality of medical care that separates quality into three components: structure, process, and outcome. An instructive analogy for understanding this framework is to imagine a food critic evaluating the quality of a restaurant. The critic might comment on the decoration and lighting ofthe restaurant, how close the tables are to each other, the extent ofthe wine list and where the chef trained. These are all evaluations of the restaurant structure. In addition, the critic might comment on whether the service was courteous and timely - measures of process. Finally, the critic might comment on outcomes like customer satisfaction or food poisoning. Similarly, to a health care critic, structure is the physical and human resources used to deliver medi cal care. Processes are the actual treatments offered to patients. Finally,outcomes are what happens to patients, for example, mortality, quality of life,and satisfac tion with care (Table 1). There is a debate about which of these measurements is the most important measure of quality.