Einstein/Montefiore Division of Critical Care Medicine

Quality Improvement

Introduction

With patient safety as its centerpiece, the Einstein/Montefiore 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 Einstein/Montefiore 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
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:

The fellowship program is accredited through the Accreditation Council for Graduate Medical Education (ACGME)'s peer review process based upon established standards and guidelines
Fellows' knowledge, skills and attitudes required to be identified as an intensive care medicine specialist are measured through the Competency Based Training Programme in Intensive Care Medicine (CoBaTrICE)'s 12 competency areas

Resources