Does standardization of critical care work?
OBJECTIVE
This article discusses how standardization of intensive care work may decrease morbidity and mortality in the intensive care unit (ICU) by reducing practice variation and improving the overall quality of care. In this context, standardization should not only apply to the specific medical management of certain high-volume ICU diagnoses but should also be established for daily ICU procedures and information transmission during ward rounds and at the interface of interdisciplinary work.


RESULTS
Standardized procedures for placement of central venous catheters, implementation of strict hand hygiene and treatment of specific high volume ICU diagnoses using protocol-guided treatment algorithms or treatment bundles have convincingly demonstrated to decrease patient morbidity and mortality and healthcare expenditures. Standardization processes to improve patient-centered communication in the ICU are still in their early stages.


CONCLUSIONS
Standardization of most aspects of intensive care medicine has an enormous potential to improve patient care and outcome, reduce ICU/hospital length of stay as well as healthcare expenditures. Despite promising results from large studies standards known to improve patient outcome have not yet been widely implemented.
Hasibeder
Walter R
WR
Department of Anaesthesiology and Critical Care Medicine, Krankenhaus der Barmherzigen Schwestern, Ried im Innkreis, Austria. Walter.Hasibeder@bhs.at
D002985:Clinical Protocols; D003422:Critical Care / Q000592:standards*; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration / Q000592:standards*; D011787:Quality of Health Care; D016896:Treatment Outcome