Institute for Healthcare Improvement: Learning and Innovation Community: Implementing an Idealized Model for Critical Care

Available through the IMPACT network or on a direct-enroll basis, IHI’s most intensive front-line improvement work happens in Learning and Innovation Communities. These are collaborative change laboratories in which teams from a wide variety of organizations work with each other and IHI faculty to rapidly test and implement meaningful, sustainable change within a specific topic area.

Listen Listen to an informational call on Implementing an Idealized Model for Critical Care.

Implementing an Idealized Model for Critical Care is available either through membership in the IMPACT network or through direct enrollment in the Community. Learn more about IMPACT.

The Challenge

The Solution

Intensive care units provide highly complex medical care requiring precision, synchronization, and coordination of multiple services and personnel. Intensive care is not only complex, it is also expensive. Despite numerous local improvements in various elements of ICU care, many promising improvements remain unused, fragmented, isolated, and dispersed. Errors occur in ICUs at unacceptable rates. Consumers, payers, and regulators are demanding significant improvements in care, and the imperative for dramatic improvement will continue to strengthen.

Viewed within the hospital or health system as a whole, suboptimal care of patients in intensive care units can result in “upstream” problems such as ambulance diversions or “downstream” problems such as delays in transfers to more cost-efficient levels of care. All of these consequences can detract from the quality of patient care, add unnecessary burden to the workforce, and waste money and time.

The Critical Care Learning and Innovation Community is designed to close the gap between what is known and what is practiced, and to establish new systems of care in critical care settings. Participants will focus on:

Improving the safety, effectiveness, and reliability of care
Implementing new models of communication and coordination among the care team members
Providing more patient- and family-centered care
Instituting efficient processes through application of “lean” approaches

Areas of Focus

Eliminate inappropriate days in the ICU
Reduce infections resulting from mechanical ventilation and central lines
Implement early identification and optimal treatment of sepsis
Institute intensive glucose management
Shorten weaning times from ventilators
Reduce sedation costs for patients on mechanical ventilation
Reduce adverse events in the ICU
Implement multidisciplinary rounds and daily goals sheets
Decrease delays in discharge by improving throughput of ICU patients
Improve efficiency by focusing on value-added processes and removing waste

Aims

Participants will be asked to test changes aimed at achieving ambitious goals:

ICU mortality reduction of at least 20%
Adverse events reduction of 75%
Reduction of catheter-related blood stream infections by at least 30%
Reducing ventilator days and ventilator-associated pneumonias
Speeding admissions and discharges
Sepsis mortality reduction of 25%
Increase patient and family participation and satisfaction with care
Increase staff satisfaction and reduce turnover