Quality Improvement
With patient safety as its centerpiece, the Montefiore Einstein Division of Critical Care Medicine has a team of expert first responders with strong professional norms who offer quality care 24/7 throughout the hospital. Our purpose is to decrease variation in medical practice and the rates of avoidable complications such as "never events" and failure to resuscitate by improving our infrastructure, processes, and outcomes. Additionally, we strive to align our goals with those of the Montefiore Einstein Strategic Plan, decreasing system fragmentation and changing cultural norms to assure organizational coherence.
Target Improvement Areas
- Central Line-Associated Infections (CLABs) (PDF)
- Surgical Site Infections
- Ventilator-Associated Pneumonia Rates (PDF)
- Ventilator Compliance: Ventilator Bundle Checklist (PDF)
Initiatives
- Simulation Programs
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Increased Transparency in the ICU:
Physician Questionnaire (PDF)
Physician Questionnaire Results (PDF)
Patient Questionnaire (PDF)
Patient Questionnaire Results (PDF) - Process Improvement Methods: With the goal of improved outcomes, Critical Care Medicine is measuring the actual rates of ventilator compliance and setting goals, tracing measurements, and calculating the upper and lower limits of compliance to see whether goals are being achieved.
Services
- Cardiac Arrest Teams: timely expert assistance in crisis situations such as rapid response and cardiac arrests
- Central Line Service (ultrasound guided)
- Chronic Critically Ill Patient Follow-Up
- ICU Without Walls
- Medical Directive Designees: surrogacy for patients who cannot give consent and are without next of kin or healthcare proxy to make medical decisions
- Rapid Response Teams
Measures
Critical Care Medicine uses the Dartmouth Atlas of Healthcare-defined efficiency and effectiveness measures.
- Length of stay
- Mortality
Evaluation
The Critical Care Medicine Fellowship Training Program integrates nationally and internally recognized evaluation measures:
Resources
- Agency for Healthcare Research and Quality (AHRQ)
- Critical Care Medicine Organization Chart
- Healthcare Improvement: Dr. Daniela Levi's presentation to fellows summarizing the Institute of Medicine's report on healthcare quality and the six aims for improvement as designated by the Institute for Healthcare Improvement
- Institute for Healthcare Improvement (IHI)
- Leapfrog Group for Patient Safety
- Patient Safety Bundles for Critical Care: Presentation given by Richard H. Savel, MD, FCCM