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The Institute of Medicine (IOM) published a landmark report in 2001(1) recommending a thoughtful new health care delivery framework to improve the quality of care for the American population in the 21st century. The IOM defined six quality domains that should be at the foundation of how we deliver critical care services: safety, timeliness, efficacy, efficiency, patient-centeredness, and equitability. However, critical care resources are limited and are not available to all, raising major concerns regarding how these resources are allocated. There are myriad reasons for the shortage of critical care services, which have led to the development of policies to improve the utilization of, and in turn often ration, these scarce resources.(2)

What every intensivist should know about intensive care unit admission criteria