Figuring out what works: a need for more and better studies on the relationship between ICU organization and outcomes

Modifying how intensive care units (ICUs) are organized and run offers major opportunities to improve outcomes. In the previous issue of Critical Care, Billington and colleagues assessed the association of outcomes with intensivists' base speciality. However, very little is known about the relationships between ICU organization and outcomes. In the systems-based paradigm of quality improvement, every aspect of what we do and how we do it is a candidate for study and change. While we need much more rigorous research assessing every aspect of this large question, there are substantial barriers to conducting such studies.