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* From the Case Western Reserve University School of Medicine at MetroHealth Medical Center, Cleveland, OH.
Correspondence to: Allan Garland, MD, MA, Division of Pulmonary and Critical Care Medicine, MetroHealth Medical Center, 2500 MetroHealth Dr, Cleveland, OH 44109; e-mail: agarland{at}metrohealth.org
ICUs are a vital component of modern health care. Improving ICU performance requires that we shift from a paradigm that concentrates on individual performance to a different paradigm that emphasizes the need to assess and improve ICU systems and processes. This is the first part of a two-part treatise. It discusses existing problems in ICU care, and the methods for defining and measuring ICU performance.
Key Words: health services research ICU organization and administration quality of health care total quality management
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