Developing and implementing quality initiatives in the ICU: strategies and outcomes.

The Institute of Medicine identifies quality health care as care that is safe, time, effective, efficient, equitable, and patient centered. In the ICU, where patients who have complex, high-acuity are at increased risk of complications, morbidity, and mortality, promoting quality-focused case is especially important. This article describes several performance-improvement initiatives that were developed and implemented a Midwestern community hospital during a 4-year period. The initiatives to reduce catheter-associated blood stream infections, to identify early sepsis, and to promote evidence-based care.