Improving quality and safety in the ICU: a challenge for the next years

The objective of this review is to focus on recent developments in ICU quality improvement.

Quality improvement has been subjected to an extensive discussion in the last two decades. Reasons for improving quality in the ICU cover many areas: Customer preferences have been focused as the main target for designing processes throughout the whole industry of services. New bioethics principles: patient autonomy and therapeutic limitation in the nonrecoverable patient, have changed the concept of ICU mission and quality improvement. Economical reasons: Cost of nonquality in long term vision is more expensive than investing in improving quality. Social imperatives: Equity in access to safe healthcare services is claimed everywhere in the world. Discussion about medical errors and patient safety: Errors have been visualized more as a lack of barriers in process designing than a responsibility of the health team participating in patient care.

Changes described above have impacted the whole practice of intensive care. Quality improvement and offering a safer healthcare will promote deep changes in management and leadership.