Application of analytic hierarchy process for measuring and comparing the global performance of intensive care units

Purpose: To develop a model for the global performance measurement of intensive care units (ICUs) and to apply that model to compare the services for quality improvement. Materials and Methods: Analytic hierarchy process, a multiple-attribute decision-making technique, is used in this study to evolve such a model. The steps consisted of identifying the critical success factors for the best performance of an ICU, identifying subfactors that influence the critical factors, comparing them pairwise, deriving their relative importance and ratings, and calculating the cumulative performance according to the attributes of a given ICU. Every step in the model was derived by group discussions, brainstorming, and consensus among intensivists. Results: The model was applied to 3 ICUs, 1 each in Barbados, Trinidad, and India in tertiary care teaching hospitals of similar setting. The cumulative performance rating of the Barbados ICU was 1.17 when compared with that of Trinidad and Indian ICU, which were 0.82 and 0.75, respectively, showing that the Trinidad and Indian ICUs performed 70% and 64% with respect to Barbados ICU. The model also enabled identifying specific areas where the ICUs did not perform well, which helped to improvise those areas. Conclusions: Analytic hierarchy process is a very useful model to measure the global performance of an ICU. © 2005 Elsevier Inc. All rights reserved.

Managing healthcare quality in project management framework

Healthcare professionals routinely deploy various quality management tools and techniques in order to improve performance of healthcare delivery. However, they are characterised by fragmented approach i.e., they are not linked with the strategic intent of the organisation. This study introduces a holistic quality improvement method, which integrates all quality improvement projects with the strategic intent of the healthcare organisations. It first identifies a healthcare system and its environment. The Strengths, Weaknesses, Opportunities and Threats (SWOT) of the system are then derived with the involvement of the concerned stakeholders. This leads to developing the strategies in order to satisfy customers in line with the organisation's competitive position. These strategies help identify a few projects, the implementation of which ensures achievement of desired quality. The projects are then prioritised with the involvement of the concerned stakeholders and implemented in order to improve the system performance. The effectiveness of the method has been demonstrated using a case study of an intensive care unit at the Eric Williams Medical Sciences Complex Hospital in Trinidad. Copyright © 2007 Inderscience Enterprises Ltd.