How safe is my intensive care unit? Methods for monitoring and measurement.
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?
Berenholtz
Sean M
SM
Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231, USA. sberenho@jhmi.edu
Pustavoitau
Aliaksei
A
Schwartz
Steven J
SJ
Pronovost
Peter J
PJ
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*