Intensive Care Unit Operational Modeling and Analysis

Rationale For A Systems Approach To Reducing Error In The Icu

ICU systems are complex. The components of the system include patients, family members, physicians, nurses, allied health staff, support staff, physical and electronic infrastructure, equipment, supplies, processes and culture (Schmidt & Taylor, 1970). Ideally these components work together to optimize patient-centered outcomes. In order to ensure that ICU systems deliver high quality care to patients we need to understand how each system component (patient, provider, equipment, etc.) interacts and works together. This understanding is not easily derived from conventional analytic approaches and optimization of the system can not rely solely on single interventions such as those aimed at improving an individual provider’s skills. , Systems-based approaches to error prevention have proven markedly effective in reducing medical errors and iatrogenic complications. For example, Dr. Pronovost’s use and distribution of a simple checklist during central line insertion has already “saved more lives than that of any laboratory science discoveries in the past decade” (Gawande, 2007). Similarly, a simple systems intervention, the WHO Surgical Safety Checklist, has been shown to reduce morbidity and mortality in a diverse group of hospitals around the world (Haynes et al., 2009). These examples demonstrate that the systems of care delivery are an important determinant of critical illness outcomes.