الفهرس 
Quality indicators in ICUOnly 14 pages are availabe for public view
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Abstract
Health care providers are striving to improve patient outcome while reducing costs. Assuring a high quality care and reducing hospital stay are considered the cornerstone for achieving this goal. As with medicine in general, continued improvements in ICU patient outcomes require the development of a health care system that is effective, efficient, safe, patient-centered, timely, and equitable. Within the last decade, healthcare systems have begun to recognize many of the advantages of practicing evidence based medicine (EBM). Frequently termed ‘‘best practice’’ guidelines, the use of protocols does not guarantee instant improvement in the quality of care. However, it does offer tools for the pursuit of this objective if it is implemented and applied with clinical acumen, with attention to individual subtleties, and with an understanding of the basic theories of quality improvement. As ICU physicians increasingly assume leadership roles in the pursuit of higher quality ICU care, their ‘change-process literacy’ will become essential. Critical illness is associated with a wide array of serious and troublesome long-term sequelae like Catheter-related blood stream infections (CRBSIs), ventilator-associated pneumonia (VAP), and Foley-related urinary tract infections (CA-UTIs) that may interfere with achieving optimal patient-centered outcomes. Although traditional short-term outcomes, such as hospital mortality, remain extremely important, they are unlikely to be adequate surrogates for subsequent patient-centered outcomes. As such, it is important to focus specifically on how critical illness and intensive care can affect long-term health and well being. A care bundle is a multi-interventional approach to managing a particular aspect of care, often a multi factorial clinical problem developed by the Institute for Healthcare Improvement .Care bundles comprise a collection of processes that when delivered to the patient altogether they significantly improve patient care outcomes .Ideally the care bundle should be small and straightforward with each element within it supported by the highest level of evidence available at that time. All components of the bundle must be delivered to ensure improvements in clinical care and outcomes, not just some of them. The idea, therefore, is not to replace physician expertise with fixed instructions, but to use standardized protocols or bundles as ever-present prompts for each supported intervention in order to minimize human error. By combining the use of bundles of care with the individual expertise of an experienced clinician, you can improve patient care by using the strengths of both. Those institutions that have the best outcomes tend to be the ones using care bundles to optimize their implementation. In this review, we will discuss creation and implementation of care bundles in ICU as a tool for improving outcome.