RT Book, Section A1 Adelman, Jason A2 Oropello, John M. A2 Pastores, Stephen M. A2 Kvetan, Vladimir SR Print(0) ID 1136413346 T1 Patient Safety in the ICU T2 Critical Care YR 1 FD 1 PB McGraw-Hill Education PP New York, NY SN 9780071820813 LK accessmedicine.mhmedical.com/content.aspx?aid=1136413346 RD 2024/03/28 AB KEY POINTSThe intensive care unit (ICU) is particularly prone to medical errors as patients are very ill and require continuous monitoring.A patient safety program that drives improvement for critical care patients can be categorized into 4 general domains: (1) ensuring compliance with patient safety regulations; (2) responding to adverse events by performing root cause analyses and implementing targeted corrective actions; (3) applying evidence-based risk reduction strategies that are not required by regulations, but are considered best practices; and (4) implementing strategies to meet and exceed patient safety metrics that are publicly reported or tied to pay-for-performance programs.To prevent wrong patient errors, the Joint Commission requires the use of at least 2 patient identifiers when administering medications and blood products, when collecting laboratory specimens and taking imaging tests, and when providing any type of treatment.The majority of adverse events are never reported and therefore cannot be addressed.When a serious adverse event happens to a critical care patient, a systematic investigation of the event, called a root cause analysis, should be completed by an interdisciplinary team that has expertise in the areas involved in the event.According to the Just Culture concept, the major focus of an adverse event investigation should be on potential system failures that led to the error as opposed to simply attributing blame to the providers involved in the error.Team training is a well-established approach for preventing errors in high-risk industries such as the military and the airline industry, and is now being applied to the medical industry.Simulation is a promising new strategy for improving patient safety. Similar to flight simulators used by the airline industry, health care simulators allow providers to learn a procedure or protocol using high-tech mannequins instead of live patients.Pay-for-performance is a new approach for driving improvement in medical care by using financial incentives to reward hospitals that perform well on preestablished safety and quality measures.Those who want to lead in patient safety should innovate new approaches for preventing errors, and study these approaches using rigorous research methodology.