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Intensive Care Unit Quality Improvement Checklist

Explain the process that was used to develop the Quality Program

To develop the quality program, Simpson, Peterson, and O’Brien-Ladner (2007) utilized “Shewhart and Deming’s plan-do-study-act methodology” (p. 185) to create an initial checklist for screening. The study was given to different doctors and nurses to gain feedback. After the collected feedback had been taken into account, the checklist was updated and tested for a week (Simpson et al., 2007).

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Once more additional changes had been made, the improved checklist was printed and given to all the members of the staff who were responsible for managing the aspects of care corresponding to the items on the checklist (Simpson et al., 2007). Thus, the personnel of the ICU started using it regularly. Over time, some additional enhancements were made to the checklist, and the latest edition of it was published in the article (Simpson et al., 2007).

What was the historical basis of the program?

The authors of the checklist were inspired to improve the quality of care when they became uncertain about whether they provided the highest quality care in their ICU after viewing some data and participating in a consortium (Simpson et al., 2007). Once it was discovered that they were not adhering to best practices, the authors initiated interdisciplinary morning quality rounds including various members of the staff (Simpson et al., 2007).

The authors were not entirely satisfied that this provided a comprehensive overview of what their mistakes and omissions were, and decided that they needed a way to make sure that every important aspect of medical care was covered for each patient every day (Simpson et al., 2007). The authors utilized the idea of creating a checklist that they found in the aviation industry, where it successfully had been used for decades (Simpson et al., 2007). They discovered that checklists also had been successfully employed in ICUs, but found no comprehensive checklists that would satisfy all their needs, so they decided to create one themselves (Simpson et al., 2007).

What are “best practices”, how are they determined and who decides them?

Generally speaking, “best practice” in medicine can be defined as the best manner for identifying, gathering, assessing, distributing, and otherwise making use of the information of the health condition of a patient, as well as for regularly checking and controlling the outcomes of all efforts taken to improve such health conditions (Perleth, Jakubowski, & Busse, 2001; Sheridan, 2016). These “best practices” are most often determined by critically analyzing the situation and looking for ways to improve it while taking into account the available theoretical data and the already existing practical findings (Sheridan, 2016).

It should be noted that such a method for improving medical practice is often referred to as “evidence-based practice” (Sheridan, 2016). Which particular methods and best practices should be used is often decided on-site (e.g., in hospitals or other medical facilities) by the members of medical care staff and management. Clinics often also have routines that stipulate the use of certain best practices while caring for patients. Additionally, medics may decide which best practices to use when determining ways of treating and caring for particular patients.

Do you think this would be a feasible program for your workplace or any hospital or institution you have worked for in the past?

On the whole, the checklist provided by Simpson et al. (2007) was created for and is suitable for intensive care units, but may not be appropriate for other units or departments within a medical facility. However, the methods for creating a similar checklist could probably be used in any medical department. It appears likely that creating and using such a checklist might be able to considerably improve the quality of health care in virtually any medical facility, including my current workplace.

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Perleth, M., Jakubowski, E., & Busse, R. (2001). What is ‘best practice’ in health care? State of the art and perspectives in improving the effectiveness and efficiency of the European health care systems. Health Policy, 56, 235-250.

Sheridan, D. J. (2016). Evidence-based medicine: Best practice or restrictive dogma. London, UK: Imperial College Press.

Simpson, S. Q., Peterson, D. A., & O’Brien-Ladner, A. R. (2007). Development and implementation of an ICU quality improvement checklist. AACN Advanced Critical Care, 18(2), 183-189.

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