Ventilator Ventilator-Associated Associated Pneumonia Pneumonia ...

Specific Quality improvement interventions Use evidence-based bundle elements Insure local resources capable of supportingselected bundle elements Do not become bound to any single bundle ifit is found to be ineffective or impractical toimplementMeasurable Outcomes Focus on compliance with process elements Select limited but clinically relevant outcomemeasures (e.g. VAP incidence, antibiotic use,duration of ventilation) Guard against reporting biases, especiallywhen using before-after or time-senesmethodsAchievable Programme Target one problem or outcome at a time Do not overreach local resource capability Develop a local approach to qualityimprovement that can be applied tosubsequent problems or outcomesRelevant Quality Improvement Programme Target problems or outcomes that havedirect significance and consequences topatient care (e.g. improved compliance withsedation holiday protocols) Update quality improvement programmessuch as new information, technology, orresources become available Employ periodic reviews of all qualityimprovement programmes by unbiasedindividuals to evaluate their success andcost-effectivenessTime-Bound Programme Employ discrete time periods for theimplementation and evaluation of eachquality improvement programme Develop objective parameters to determinewhether quality improvement interventionsshould continue, be modified, ordiscontinued Avoid having quality improvementprogrammes in place without definite periodsor reevaluationKollef MH. Crit Care Med 2012; 40: 271-277