Saving Lives
Hospitals have signed on to a six-part plan to avoid a multitude of unnecessary deaths
So last December, at an annual gathering of hospital and public and private healthcare leaders who went to Orlando to exchange ideas on safety and quality improvements, Berwick took the microphone. "I'm losing my patience," he announced, and then offered a challenge: Join IHI in an ambitious initiative called the 100K Lives Campaign. Its goal is to save 100,000 hospital patients' lives by 9 a.m. on June 14, 2006, exactly 18 months from Berwick's call to arms, by introducing six changes in hospital procedures. Each change addresses a problem, such as deaths from infections following surgery, and presents an arsenal of weapons to fight it, such as tighter timing of antibiotic doses before surgery.
Making real changes. Most of the proposed initiatives are "tried and true," says JCAHO President Dennis O'Leary, whose group worked closely with IHI to select and refine the measures. Reducing deaths from medication errors, for instance, is already a JCAHO patient safety goal, and the measures that reduce deaths in heart-attack patients are the same ones now being tracked on the CMS Hospital Compare site. But there are some new ideas, too. "Rapid-response teams," called when a patient seems to be losing ground but isn't yet a true emergency, is an innovative concept for U.S. hospitals.
Joining the 100K project involves no fee, and paperwork is minimal. Still, some might be reluctant to sign on. Many of the measures cost little to put in place, but others, such as reducing medication errors, can involve expensive new technology.
Yet many hospitals actually jumped at this opportunity to make these lifesaving changes. By June's end, more than 2,300 were on board--more than enough to meet the 100,000 goal. If all 6,000-some U.S. hospitals joined, says IHI, 183,000 lives could be saved every year.
Two early adopters were Hackensack University Medical Center, a large teaching hospital in northern New Jersey with nearly 700 beds, and McLeod Regional Medical Center, a 460-bed community hospital in Florence, a small city in the northeast corner of South Carolina. The following pages describe the six parts of the 100K initiative and how these two hospitals are meshing them into the hospital routine.
Saving 100,000 Lives, One By One
The goal of the Institute for Healthcare Improvement's 100K Lives Campaign is to reduce inpatient deaths by 100,000 a year. IHI says 75 lives a year easily could be saved at a moderately sized hospital with 15,000 patient admissions annually--call it "Metro General." Many hospitals are much smaller, so to reach 100,000 lives IHI had to enlist 2,300 hospitals--which it has done. If all 6,000 U.S. hospitals signed on, IHI says, 183,000 lives a year could be saved.
Reaching for 183,000 lives
Enough hospitals have signed up for IHI to feel confident of reaching its 100,000 goal. But if every U.S. hospital took part 183,000 lives could be changed:
Targeted: 100,000 (55 pct.)
Remaining: 83,000 (45 pct.)
One hospital could save 75 lives each year
A hospital seeing 15,000 patients a year could save at least 75 lives by putting the six parts of the 100K Lives Campaign in place.
45 from rapid-response teams
7.5 by reducing central-venous-line infections
7.5 from improved care for heart-attack victims
7.5 by reducing ventilator-related pneumonia
6 by preventing surgery-related infections
1.5 by reducing medication errors
Danny Dougherty-- USN&WR
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