Establishment of the Rocky Roll Cardiac Rapid Diagnostic Center to assist with early detection and treatment of heart attacks(April, 2005) Reduction in average post-surgical ventilation time from over 12 hours to less than 7 hours (Ongoing) Reduction in time from patient arrival with a heart attack to going for percutaneous cardiac intervention (Door to Balloon Time). Our median time from January - June, 2006 is 80 minutes. (Ongoing) Implementation of evidence-based medical practices for heart attack and heart failure patients, as well as surgical infection prevention initiatives. (Ongoing) Reduction in ventilator-associated pneumonias in our Surgical ICU to less than the national average through participation in Keystone evidence-based medical practice initiatives. (Ongoing)

Establishment of the Rocky Roll Cardiac Rapid Diagnostic Center to assist with early detection and treatment of heart attacks(April, 2005) Reduction in time from patient arrival with a heart attack to going for percutaneous cardiac intervention (Door to Balloon Time). Our median time from January - June, 2006 is 80 minutes. (Ongoing) Implementation of evidence-based medical practices for heart attack and heart failure patients, as well as surgical infection prevention initiatives. (Ongoing) Implementation of Keystone evidence-based medical practice initiatives in all ICUs. (Ongoing)

All patients are screened for beta-blockers prior to induction as part of our Anesthesia protocol. However, we do not have a measurement. Member of the Michigan chapter of the National Surgical Quality Improvement Project that focuses on generaland vascular surgery. Attention is to mortality, morbidity and other patient outcomes.

Member of the Michigan chapter of the National Surgical Quality Improvement Project that focuses on general and vascular surgery. Attention is to mortality, morbidity and other patient outcomes.

Reduction in average post-surgical ventilation time from over 12 hours to less than 7 hours (Ongoing) Reduction in ventilator-associated pneumonias in our Surgical ICU to less than the national average through participation in Keystone evidence-based medical practice initiatives. (Ongoing) Implementation of Keystone evidence-based medical practice initiatives in all four of our ICUs. (2005) Reduction in medication delivery times due to revised medication delivery process. (2006) Implementation of a Bed Tracking System to allow improved throughput in the ICUs. (September, 2006) - Added additional critical care beds - Centralized medication distribution - Pyxis Connect (faxing physician orders) - Medication Reconciliation - SBAR Communication - Sharps Injury Reduction - Hand-off Communication between shifts - Signature Care - GEMS Computerized Documentation - Several upgrades - Implementing new physiological monitoring - Ergologix: Lift Equipment Installation -Barton Chairs implemented - Bed ready project to help with thru-put - SKINN - pressure ulcer prevention - VTE - Fall Prevention program - Reducing ventilator associated pneumonias (VAP) - Reducing nosocomial Blood Stream Infection (BSI) - Daily Goals - Multidisciplinary Rounds - Glycemic Control - Sepsis Bundle : MULTIPLE COMPONENTS - Central Line Policy - Role of Clinical Facilitator - Addressing 1:1 criteria (staffing) - Developing ICU Admission Order Set - ICU Family Guidelines: provides critical care education for families - Visitation policy - Implementing pagers for ICU pts' families - Pain Management - NTICU: Collaborative - Formed to address QI, M & M, etc., for trauma certification - Family Interaction Conferences - SICU: CRRT Services implemented Improvements around Bivad procedures Sternal Incision Infection project Peridex Project