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 The first step in improving care of critically ill patients is making a solid commitment to improve that care. This commitment includes a strong and well-worded aim statement that sets an aggressive global aim. It is critical that the overall aim has a measurable objective and a specified time frame. For instance, for efforts to reduce catheter-related blood stream infections (CR-BSIs), an aim might be: "Decrease the rate of CR-BSIs by 50 percent within one year, using the measure of catheter-related blood stream infections per 1,000 catheter-days."
In addition to the global aim, the work is divided into segments with each having a specific aim that is measurable and focused on achieving the over all global goal.
Each institution committed to this goal should have senior leaders involved in setting the specific aims, to ensure that these aims are aligned with the organization's strategic goals. When senior leaders approve the aims, they should also make a commitment to give the team whatever support is needed to achieve the aims.
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The following are specific aims that support the global aim of reducing mortality in the ICU. They break the work into smaller measurable achievable chunks for teams to tackle. Several teams may be working on specific aims simultaneously, with all reporting to the leadership team.
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Reduce costs in the Medical Intensive Care Unit (MICU) by 30% within 12 months, with no harm to patients.
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Decrease patients' time on mechanical ventilation in the Surgical Intensive Care Unite (SICU) by 30% within 12 months.
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Decrease costs and improve outcomes in mechanically ventilated patients by achieving the following:
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Decrease ventilator weaning time by 25%.
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Decrease number of days of ventilator dependence by 25%.
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Decrease the cost of ventilator care by 25%.
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Reduce costs and improve outcomes for critical care patients by reducing inappropriate stays in the ICU, reducing unnecessary lab expense, improving enteral feeding, reducing time on mechanical ventilation, and improving end-of-life care.
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Achieve greater than 95% compliance with all four critical components of ventilator management: PUD prophylaxis, DVT prophylaxis, HOB elevation, withholding of sedation once every 24 hours.
- In the placement of central lines, prior to placement 100 percent of personnel will exercise hand hygiene within one year.
- All ICU patients will be given deep venous thrombosis (DVT) prophylaxis (unless contraindicated) 100% of the time within 6 months.
- Once central lines are placed, on multidisciplinary rounds staff will assess for the possibility of removal each day in 100 percent of instances this year.
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