self-driven motivation for improvement. Understanding reasons for non-compliance may
identify barriers to implementation that need to be addressed or parts of the protocol
that may need to be adjusted. Simple checklists completed at the bedside can be used
to collect data on intervention compliance [ 37 ]. Monitoring and provision of real-time
feedback of compliance were instrumental in the successful implementation of previous
hand hygiene and VAP-reduction QI initiatives [ 38 - 41 ].
Key elements of the QI process include continued improvement in compliance
with protocols leading to continued improvement in the measured outcomes [ 36 ]. This is
typically achieved by providing continuous feedback to improve compliance with the
intervention and either adjusting the intervention or adding a new intervention if
maximum compliance with the initial intervention has been obtained.
QI is a continuous process. Successful adoption and maintenance of an
intervention into practice will establish new baseline levels or rates for the measured
outcome. These new rates can then be further improved upon by developing new
initiatives. QI methods can improve outcomes in pediatric critical care by reducing
variation in care and increasing the reliable use of consistent “best” practices.
marcin
(Marcin)
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