Key message Eight ICU QC indicators including 5 structural factors (patient-to-bed ratio, physician-to-bed ratio, nurse-to-bed ratio, patient-to-physician ratio, patient-to-nurse ratio) and 3 process factors (unplanned endotracheal extubation rate, reintubation rate within 48 h, and microbiology detection rate before antibiotic use) were associated with VAP incidence rate. Only 2 process factors including unplanned endotracheal extubation rate and reintubation rate within 48 h were associated with high VAP mortality, while all the 5 structural factors were not. The process factors rather than the structural factors need to be further improved for the QC of VAP in ICU.