Management strategies to effect change in intensive care units: Lessons from the world of business - Part I. Targeting quality improvement initiatives

Hayley B. Gershengorn, Robert Kocher, Phillip Factor

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

The business community has developed strategies to ensure the quality of the goods or services they produce and to improve the management of multidisciplinary work teams. With modification, many of these techniques can be imported into intensive care units (ICUs) to improve clinical operations and patient safety. In Part I of a three-part ATS Seminar series, we argue for adopting business management strategies in ICUs and set forth strategies for targeting selected quality improvement initiatives. These tools are relevant to health care today as focus is placed on limiting low-value care and measuring, reporting, and improving quality. In the ICU, the complexity of illness and the need to standardize processes make these tools even more appealing. Herein, we highlight four techniques to help prioritize initiatives. First, the "80/20 rule" mandates focus on the few (20%) interventions likely to drive the majority (80%) of improvement. Second, benchmarking - a process of comparison with peer units or institutions - is essential to identifying areas of strength and weakness. Third, root cause analyses, in which structured retrospective reviews of negative events are performed, can be used to identify and fix systems errors. Finally, failure mode and effects analysis - a process aimed at prospectively identifying potential sources of error - allows for systems fixes to be instituted in advance to prevent negative outcomes. These techniques originated in fields other than health care, yet adoption has and can help ICU managers prioritize issues for quality improvement.

Original languageEnglish (US)
Pages (from-to)264-269
Number of pages6
JournalAnnals of the American Thoracic Society
Volume11
Issue number2
DOIs
StatePublished - 2014

Fingerprint

Quality Improvement
Intensive Care Units
Root Cause Analysis
Delivery of Health Care
Benchmarking
Patient Safety
Research Design

Keywords

  • Benchmarking
  • Organization and administration
  • Quality improvement
  • Root cause analysis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Management strategies to effect change in intensive care units : Lessons from the world of business - Part I. Targeting quality improvement initiatives. / Gershengorn, Hayley B.; Kocher, Robert; Factor, Phillip.

In: Annals of the American Thoracic Society, Vol. 11, No. 2, 2014, p. 264-269.

Research output: Contribution to journalArticle

@article{b73dd04d60514173a93b2050bd2c645c,
title = "Management strategies to effect change in intensive care units: Lessons from the world of business - Part I. Targeting quality improvement initiatives",
abstract = "The business community has developed strategies to ensure the quality of the goods or services they produce and to improve the management of multidisciplinary work teams. With modification, many of these techniques can be imported into intensive care units (ICUs) to improve clinical operations and patient safety. In Part I of a three-part ATS Seminar series, we argue for adopting business management strategies in ICUs and set forth strategies for targeting selected quality improvement initiatives. These tools are relevant to health care today as focus is placed on limiting low-value care and measuring, reporting, and improving quality. In the ICU, the complexity of illness and the need to standardize processes make these tools even more appealing. Herein, we highlight four techniques to help prioritize initiatives. First, the {"}80/20 rule{"} mandates focus on the few (20{\%}) interventions likely to drive the majority (80{\%}) of improvement. Second, benchmarking - a process of comparison with peer units or institutions - is essential to identifying areas of strength and weakness. Third, root cause analyses, in which structured retrospective reviews of negative events are performed, can be used to identify and fix systems errors. Finally, failure mode and effects analysis - a process aimed at prospectively identifying potential sources of error - allows for systems fixes to be instituted in advance to prevent negative outcomes. These techniques originated in fields other than health care, yet adoption has and can help ICU managers prioritize issues for quality improvement.",
keywords = "Benchmarking, Organization and administration, Quality improvement, Root cause analysis",
author = "Gershengorn, {Hayley B.} and Robert Kocher and Phillip Factor",
year = "2014",
doi = "10.1513/AnnalsATS.201306-177AS",
language = "English (US)",
volume = "11",
pages = "264--269",
journal = "Annals of the American Thoracic Society",
issn = "2325-6621",
publisher = "American Thoracic Society",
number = "2",

}

TY - JOUR

T1 - Management strategies to effect change in intensive care units

T2 - Lessons from the world of business - Part I. Targeting quality improvement initiatives

AU - Gershengorn, Hayley B.

AU - Kocher, Robert

AU - Factor, Phillip

PY - 2014

Y1 - 2014

N2 - The business community has developed strategies to ensure the quality of the goods or services they produce and to improve the management of multidisciplinary work teams. With modification, many of these techniques can be imported into intensive care units (ICUs) to improve clinical operations and patient safety. In Part I of a three-part ATS Seminar series, we argue for adopting business management strategies in ICUs and set forth strategies for targeting selected quality improvement initiatives. These tools are relevant to health care today as focus is placed on limiting low-value care and measuring, reporting, and improving quality. In the ICU, the complexity of illness and the need to standardize processes make these tools even more appealing. Herein, we highlight four techniques to help prioritize initiatives. First, the "80/20 rule" mandates focus on the few (20%) interventions likely to drive the majority (80%) of improvement. Second, benchmarking - a process of comparison with peer units or institutions - is essential to identifying areas of strength and weakness. Third, root cause analyses, in which structured retrospective reviews of negative events are performed, can be used to identify and fix systems errors. Finally, failure mode and effects analysis - a process aimed at prospectively identifying potential sources of error - allows for systems fixes to be instituted in advance to prevent negative outcomes. These techniques originated in fields other than health care, yet adoption has and can help ICU managers prioritize issues for quality improvement.

AB - The business community has developed strategies to ensure the quality of the goods or services they produce and to improve the management of multidisciplinary work teams. With modification, many of these techniques can be imported into intensive care units (ICUs) to improve clinical operations and patient safety. In Part I of a three-part ATS Seminar series, we argue for adopting business management strategies in ICUs and set forth strategies for targeting selected quality improvement initiatives. These tools are relevant to health care today as focus is placed on limiting low-value care and measuring, reporting, and improving quality. In the ICU, the complexity of illness and the need to standardize processes make these tools even more appealing. Herein, we highlight four techniques to help prioritize initiatives. First, the "80/20 rule" mandates focus on the few (20%) interventions likely to drive the majority (80%) of improvement. Second, benchmarking - a process of comparison with peer units or institutions - is essential to identifying areas of strength and weakness. Third, root cause analyses, in which structured retrospective reviews of negative events are performed, can be used to identify and fix systems errors. Finally, failure mode and effects analysis - a process aimed at prospectively identifying potential sources of error - allows for systems fixes to be instituted in advance to prevent negative outcomes. These techniques originated in fields other than health care, yet adoption has and can help ICU managers prioritize issues for quality improvement.

KW - Benchmarking

KW - Organization and administration

KW - Quality improvement

KW - Root cause analysis

UR - http://www.scopus.com/inward/record.url?scp=84898760074&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84898760074&partnerID=8YFLogxK

U2 - 10.1513/AnnalsATS.201306-177AS

DO - 10.1513/AnnalsATS.201306-177AS

M3 - Article

C2 - 24575997

AN - SCOPUS:84898760074

VL - 11

SP - 264

EP - 269

JO - Annals of the American Thoracic Society

JF - Annals of the American Thoracic Society

SN - 2325-6621

IS - 2

ER -