title: How safe is my intensive care unit? Methods for monitoring and measurement.
abstract: OBJECTIVE
  Patient safety is attracting increasing attention. How we monitor and measure safety, however, is not well defined. In this review we describe a conceptual model for monitoring and measuring safety, describe the development of a safety scorecard, and provide an example of how this scorecard is used in the ICU.
  
  
  RESULTS
  Our safety scorecard stratifies measures into two categories. One category uses valid rate-based measures to evaluate: How often do we provide the interventions that patients should receive? (process measure); and How often do we harm patients? (outcome measure). The second category includes measures that cannot be expressed as valid rates: How do we know we learned from defects? (structural measure); and How well have we created a culture of safety? (context measure). Measures within each domain should be important and valid, and organizations should be able to use the measures to improve patient safety.
  
  
  CONCLUSIONS
  We present a framework for a patient safety scorecard to measure and monitor patient safety. This safety scorecard is a valid and practical tool for ICUs to track progress of efforts to improve patient safety and answer the question, how safe is my ICU?
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231, USA. sberenho@jhmi.edu
authors.forename: Sean M
authors.initials: SM
authors.lastname: Berenholtz
authors.forename: Aliaksei
authors.initials: A
authors.lastname: Pustavoitau
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Schwartz
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Pronovost
mesh_terms: D016638:Critical Illness; D017598:Efficiency, Organizational; D006801:Humans; D007362:Intensive Care Units / Q000592:standards*; D008396:Maryland; D008991:Monitoring, Physiologic / Q000592:standards*; D015279:Organizational Culture; D011787:Quality of Health Care / Q000592:standards*; D017751:Safety Management / Q000592:standards*