Prof. Dr. Dominique Vandijck
Dept. of Public Health and Health Economics
Dept. of General Internal Medicine and Infectious Diseases
Ghent University Hospital
Dept. of Health Economics and Patient Safety
For years, some have tried to deny their value, but today we can no longer ignore the increasing importance of applying measures to monitor and evaluate the quality of ICU care delivered. However, considering the economic crisis we are in, it is strongly apparent that there will be an increasing demand for more explicit demonstration of competence and integrity, including providing accountability for the resources received and this based on accurate checking, using measurement and surveillance.
All involved in ICU care are striving to provide high-quality care to their patients. But what is 'quality', and how can it be defined? For many, it still remains a term so vague, general and ambiguous as to be almost completely meaningless. Quality care should be as safe and cost-effective as possible, and patients should be treated with compassion, dignity and respect. Besides clinical quality, the term refers to care that is personal and well adapted to the specific needs of each individual. And yes, there is no way back, the quality debate has definitely been opened whether we want to or not. Quality and safety is now high on the agenda. Maybe, it is easy to agree with its broad aims; however, defining the specific aspects of our care that deliver this is more difficult.
Hence, in 2011 an increasing amount of literature has shown that researchers over the world are searching for a comprehensible set of reliable and evidence-based ICU quality indicators, which if upheld, will likely contribute in improving patient outcomes, safety and thus the quality of ICU care. Nevertheless, achieving this goal will highly depend upon the successful implementation of these indicators in daily ICU practice. As such, and besides the fact that additional research for measures to inform quality improvement initiatives is warranted, a next step will be to better explore potential barriers for quality indicator implementation and to identify facilitators of behavioural change. I really look forward reading the 2012 contributions on this topic!