Step 11: Initiate safety and quality culture

•This has to come from a strong leadership, primarily from the ICU director, backed by a willing management.

•This has to be backed up by full support and motivation of ICU staff.

•Adequate budget needs to be provided by the administration.

•Computerized physician order entry system goes a long way in ensuring safety in the ICU by reducing human error.

Suggested Reading

1.Rosenthal VD, Maki DG, Graves N. International Nosocomial Infection Control Consortium (INICC): goals and objectives, description of surveillance methods, and operational activities. Am J Infect Control. 2010;38(2):95–104.

Benchmark statistics on nosocomial infections from developing countries.

2.Gawande A. The checklist. The New Yorker. 2007. December 10, 2007.

A fascinating reading on medical errors.

3.Garland A. Improving the ICU: part 1. Chest. 2005;127:2151–64.

It discusses existing problems in ICU care and the methods for defining and measuring ICU performance.

4.Garland A. Improving the ICU: part 2. Chest. 2005;127: 2165–79.

This second part establishes a practical framework for performance improvement and examines specific strategies to improve ICU performance, including the use of information systems.

5.National Nosocomial Infections Surveillance System. National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2004. Am J Infect Control. 2004;32(8):470–85.

Benchmark statistics on nosocomial infections from US hospitals.

Websites

1.http://www.isccm.org

A very comprehensive guideline on quality control from developing country’s perspective.

2.http://www.semicyuc.org/calidad/quality_indicators

An exhaustive literature from Spain on quality control guideline.