Quality and Safety

Quality improvement is a goal of all institutions but effective quality improvement programs have been difficult to create and sustain. Cardiac surgery has long been a pioneer in the quality improvement process through protocolization, large database analysis, and evidence based research. This chapter will discuss the theoretical foundation for quality improvement in medicine, and address current quality improvement strategies in the cardiothoracic ICU including care bundles, large database review, and externally promulgated quality programs such as the Surgical Care Improvement Project (SCIP) or the Physician Quality Reporting Initiative (PQRS). Controversies from national quality improvement programs including SCIP, extended staffing, and the value of quality culture will be discussed.