The need for serious discussions of ICU performance metrics is overdue. We gauge the “health” of financial or business entities by measurements like price-to-earnings ratio, equity, debt load, or cash on hand. Similarly, we monitor the integrity of engineering systems by their failure rates, reliability, recovery rate, and level of redundancy. The performance measures described by Dr. Garland are good first steps toward arriving at community consensus; others may propose alternatives. The ultimate test would depend on the usefulness of these measurements in improving care in the ICU.