Scheinhorn DJ, Chao DC, Stearn-Hassenpflug MA, LaBree LD, Heltsley DJ. Post-ICU mechanical ventilation: Treatment of 1,123 patients at a regional weaning center. Chest. 1997;111(6):1654-1659.

This article outlines the varying results of weaning patients and a summary of patients relocated after prolonged mechanical ventilation (PMV) in the ICU.

Bagley PH, Cooney E. A community-based regional ventilator weaning unit: Development and outcomes. Chest. 1997;111(4):1024-1029.

This article discusses the creation of a community-based weaning unit and its results.

Gracey DR, Hardy DC, Koenig GE. The chronic ventilator-dependent unit: A lower-cost alternative to intensive care. Mayo Clinic Proceedings. 2000;75(5):445-449.

This article discusses estimating the costs and patient outcomes of a specialty hospital unit for patients who are released early from ICU.

Buerhaus PI, Staiger DO, Auerbach DI. Implications of a rapidly aging registered nurse workforce. Journal of the American Medical Association. 2000;283(22):2948-2954.

This article raises concerns about the standard age of registered nurses (RNs), which has increased substantially in the last fifteen years.

Employees. In our hands: How hospital leaders can build a thriving workforce. Trustee. 2002;55(7):30-31.

This article describes how a flourishing labor force can be established by hospital chiefs. Information is also included on how to further develop workplace partnerships.

Donchin Y, Gopher D, Olin M, et al. A look into the nature and causes of human errors in the intensive care unit. Critical Care Medicine. 1995;23(2):294-300.

This article concerns research carried out to examine the reasons behind human blunders in the ICU and the patterns that can discover them.

Angus DC, Kelley MA, Schmitz RJ, White A, Popovich J Jr; Committee on Manpower for Pulmonary and Critical Care Societies (COMPACCS). Caring for the critically ill patient. Current and projected workforce requirements for care of the critically ill and patients with pulmonary disease: Can we meet the requirements of an aging population? Journal of the American Medical Association. 2000;284(21):2762-2770.

This article is about gaining knowledge and preparing for the future with an aging workforce in health care. Two significant areas in health care are discussed: care of the critically ill and management of pulmonary disease.

Rainey TG, Kabcenell A, Berwick DM, Roessner J
Boston, Massachusetts, USA: Institute for Healthcare Improvement; 1998

**NOTE: This Breakthrough Series Guide was published in 1998 and has NOT been updated. Please be advised that much of the clinical content may be out of date.**        Institute for Healthcare Improvement’s Breakthrough Series Guide to reducing costs and improving outcomes in adult intensive care. This Guide includes topics such as: Reducing inappropriate days in the ICU; Improving ventilator management; Improving drug utilization; Preventing predictable complications; Increasing the appropriate use of ancillary services; Improving family support and end-of-life care.

Committee on Quality of Health Care in America, Institute of Medicine
Washington, DC, USA: National Academies Press; 2001

This report from the Institute of Medicine focuses on closing the quality gap between what we know to be good health care and the health care that people actually receive. The report recommends a redesign of the American health care system by providing six "Aims for Improvement": Safety, Effectiveness, Patient-Centeredness, Timeliness, Efficiency, Equity. These principles set forth a specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others to improve the US health care system.

Young MP, Birkmeyer JD. Potential reduction in mortality rates using an intensivist model to manage intensive care units. Effective Clinical Practice. 2000;3(6):284-289.

This paper discusses the benefits and risks of applying an intensivist model to manage ICUs (i.e., managed by critical care physicians) to determine effects on outcomes and potential reductions in death rates.