Effort to cut errors works better than expected
The Institute for Healthcare Improvement (IHI) in Cambridge, MA, announced recently that U.S. hospitals taking part in an 18-month effort to prevent 100,000 unnecessary deaths by dramatically improving patient care have exceeded that goal. Hospitals enrolled in the 100,000 Lives Campaign have collectively prevented an estimated 122,300 avoidable deaths and have begun to institutionalize new standards of care to improve safety, the group reports.
Initiated by IHI in December 2004, the campaign has enrolled more than 3,000 hospitals — representing an estimated 75% of U.S. hospital beds and far surpassed the enrollment original goal of 2,000. The participating hospitals have pledged to implement up to six evidence-based and life-saving interventions. Donald Berwick, MD, president and CEO of IHI, announced the results at IHI's annual International Summit on Redesigning Hospital Care. He says the campaign has exceeded his highest expectations.
"The participating hospitals have not only prevented an estimated 122,300 unnecessary deaths, but they've also proven that it's possible for the health care community to come together voluntarily to rapidly make significant changes in patient care," he says. "I have never before witnessed such widespread collaboration and commitment on the part of health care leaders and front line staff to move the system giant steps forward."
More than 20 facilities have reported that they have gone more than a year without a case of ventilator-associated pneumonia, a leading killer among all hospital-acquired infections, which demonstrates that this sort of complication can be avoided, Berwick says. Hundreds of hospitals also have instituted rapid response teams, a relatively new concept that is saving lives. Participating hospitals also have made great headway in delivering reliable care for acute myocardial infarction, preventing adverse drug events, and preventing surgical site and central line infections.
Berwick says the campaign has led hospitals and health care systems to cooperate at unprecedented levels. Without regulatory mandates or financial incentives, groups of facilities on the regional, state, and community level have come together to exchange solutions and strategies to support improvement. Campaign participants are sharing ideas and examples of success on IHI's web site at www.ihi.org/IHI/Results/SuccessHeadlines.
Hospitals that participated in the 100,000 Lives Campaign committed to implementing some or all of the following six quality improvement changes:
- Activate a Rapid Response Team at the first sign that a patient's condition is worsening and may lead to a more serious medical emergency. (There are 1,781 hospitals participating.)
- Prevent patients from dying of heart attacks by delivering evidence-based care, such as appropriate administration of aspirin and beta-blockers to prevent further heart muscle damage (2,288 hospitals participating).
- Prevent medication errors by ensuring that accurate and continually updated lists of patients' medications are reviewed and reconciled during their hospital stay, particularly at transition points (2,185 hospitals participating).
- Prevent patients who are receiving medicines and fluids through central lines from developing infections by following five steps, including proper hand washing and cleaning the patient's skin with chlorhexidine (1,925 hospitals participating).
- Prevent patients undergoing surgery from developing infections by following a series of steps, including the timely administration of antibiotics (2,133 hospitals participating).
- Prevent patients on ventilators from developing pneumonia by following four steps, including raising the head of the patient's bed between 30 and 45 degrees (1,982 hospitals participating).
For more information on the 100,000 Lives Campaign, contact:
- Donald Berwick, MD, President, Institute for Healthcare Improvement, 20 University Road, Seventh Floor, Cambridge, MA 02138. Telephone: (617) 301-4800.