Interaction of quality and finance in the intensive care unit

The interaction between quality and finance in the intensive care unit (ICU) is complicated. While efforts to improve financial performance may inadvertently lead to reduced quality and safety, the converse is not necessarily true. Research is beginning to show that although more costly in the short term, investments in quality and safety help improve long term financial performance. This interplay of quality and finance in the ICU illustrates a broader discussion regarding quality and finance in health care. The ICU is among the most complex parts of the health care system with exceptionally skilled professionals treating the sickest patents, yet consumes a disproportionate amount of resources and is characterized by an epidemic of quality and safety lapses.This article looks at quality, safety, and finance in the ICU by examining 3 specific topics: (1) the business case for quality, (2) current and expected payment reforms that will effect quality, and (3) a discussion of Lean, a transformative management model with specific applicability to improve quality and financial performance in the ICU.