TABLE 1 ] .
Examples of Value Metrics, Institute of Medicine Aim, and Description
| Metric | Aim | Description |
| Global | ||
| Unadjusted ICU mortality26, a | S, E, P, Q | Percentage of patients in the ICU who die in the ICU |
| Risk-adjusted ICU mortality27 | S, E, P, Q | Percentage of patients in the ICU who die in the ICU adjusted for severity of illness |
| Unadjusted ICU length of stay26, a | S, E, F | Mean ICU length of stay for all discharges (including deaths and transfers) |
| Delayed ICU admission26 | T, E, Q | Percentage of ICU admissions (excluding interhospital transfers) delayed ≥ 4 h between order and transfer |
| ICU readmission26 | S, E, P, F | Percentage of unplanned ICU readmissions within 48 h |
| Patient falls28 | S, P | Number of falls per 1,000 patient days |
| Pressure ulcers29 | S, E, P, F | Number of new-onset pressure ulcers per 1,000 patient days |
| Medication errors30 | S, T, E, F | Percentage of administered medication doses with errors |
| ICU costs4 | F | Average ICU costs per day |
| Patient/family satisfaction31 | P | Average level of reported satisfaction (Family Satisfaction in the Intensive Care Unit survey) |
| Neurologic | ||
| Pain32 | T, E, P | Percentage of patient days during which pain was evaluated four or more times per shift and at a nonsignificant level |
| Agitation32 | T, E, P | Percentage of patient days during which sedation was evaluated four or more times per shift and at either optimal or target sedation level |
| Delirium32 | S, E, P | Percentage of patient days during which delirium was evaluated once per shift and delirium not present |
| Weakness33 | S, E, P | Percentage of patients with clinically detected weakness with no plausible cause other than critical illness |
| Pulmonary | ||
| Mechanical ventilation duration26 | S, E, P, F | Mean number of days on mechanical ventilation for all patients receiving any invasive mechanical ventilation |
| ARDS34 | S, E, P, F | Number of new-onset ARDS per 1,000 ventilator days |
| Unplanned extubations35 | S, E, P, F | Number of unplanned extubations per 1,000 ventilator days |
| Infectious disease | ||
| CLABSI36, b | S, E, P, F | Number of CLABSIs per 1,000 catheter days |
| CAUTI37, b | S, E, P, F | Number of CAUTIs per 1,000 catheter days |
| Probable VAP38 | S, E, P, F | Number of probable VAPs per 1,000 ventilator days19 |
| MRSA infection26 | S, E, P, F | Number of MRSA infections per 1,000 patient days |
| VRE infection26 | S, E, P, F | Number of new-onset VRE infections per 1,000 patient days |
| Clostridium difficile infection39, a | S, E, P, F | Number of new-onset C difficile infections per 1,000 patient days |
| GI | ||
| GI bleeding40 | S, E, P, F | Percentage of patients in whom macroscopic bleeding develops, resulting in hemodynamic instability or the need for RBC transfusion |
| Hematologic | ||
| VTE41 | S, E, P, F | Percentage of patients with new-onset VTE |
| Transfusion reaction42, a | S, E, P, F | Percentage of transfused units with a reaction |
CAUTI = catheter-associated urinary tract infection; CLABSI = central line-associated bloodstream infection; E = effective; F = efficient; MRSA = methicillin-resistant Staphylococcus aureus; P = patient centered; Q = equitable; S = safe; T = timely; VAP = ventilator-associated pneumonia; VRE = vancomycin-resistant enterococci.
a
National Quality Forum endorsed.
b
Centers for Disease Control and Prevention/National Healthcare Safety Network reporting.