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Quality Measures for Critically Ill PatientsVentilator-Associated Condition: Where Does Ventilator-Associated Condition Fit in?

Craig M. Lilly, MD, FCCP; Richard T. Ellison, III, MD
Author and Funding Information

From the Department of Medicine (Drs Lilly and Ellison), Departments of Anesthesiology and Surgery (Dr Lilly), Clinical and Population Health Research Program (Dr Lilly), Graduate School of Biomedical Sciences (Drs Lilly and Ellison), and Microbiology and Physiological Systems (Dr Ellison), University of Massachusetts Medical School; and UMass Memorial Health Care (Dr Ellison).

Correspondence to: Craig M. Lilly, MD, Departments of Anesthesiology and Surgery, University of Massachusetts Medical School, UMass Memorial Medical Center, 281 Lincoln St, Worcester, MA 01605; e-mail: craig.lilly@umassmed.edu


Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;144(5):1429-1430. doi:10.1378/chest.13-1887
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Extract

The commitment to disease prevention is a foundational ethical principle that is promoted in the mission statements of many medical associations including the American Association of Critical-Care Nurses, the American College of Chest Physicians, the American Thoracic Society, the Infectious Diseases Society of America, and the Society of Critical Care Medicine. The application of this principle to patients who are mechanically ventilated has caused the Centers for Disease Control and Prevention (CDC) Division of Healthcare Quality to seek the support of the leaders of these societies that make up the Critical Care Societies Collaborative for a new approach to detecting and reporting complications of mechanical ventilation using a new construct termed ventilator-associated condition (VAC). Although the definition for this condition has changed several times, all of its forms primarily measure changes made to mechanical ventilator settings. This approach to detecting complications of mechanical ventilation is unique because it focuses on provider behavior rather than on biologic or physiologic changes in the patient. In light of this unconventional approach, it is appropriate that the CDC Division of Healthcare Quality Promotion VAP Surveillance Working Group has advocated close attention to the results of initial measurements, which have already identified unintended consequences reflected in a change in the definition published in January 2013.1,2

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