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Implementing clinical practice changes in critical care: lessons learned in a national collaborative of over 60 ICU teams.

Improving care in the intensive care unit (ICU) is a global area of focus for clinicians worldwide. The complexity of the ICU environment, compounded by multiple patient comorbidities and high acuity levels, makes the ICU a unique and challenging area of clinical practice. The essence of quality improvement - designing and implementing strategies to enhance care - fit well with the ICU setting. However, implementing clinical change is challenging, regardless of the clinical setting. A national collaborative targeting ICU settings was initiated which provided a number of lessons learned regarding implementing quality of care initiatives in critical care. This article highlights quality improvement strategies for implementing clinical practice changes in the ICU to enhance care, based on reports from over 60 ICUs participating in the collaborative.