PRESS RELEASE

For Immediate Release
Date: May 22, 2007

Do No Harm: Hospitals Search for Ways to Improve Patient Care and Safety
 

RICHMOND, Va. -- Just over two years ago, Virginia hospitals throughout the commonwealth joined the 100,000 Lives campaign, a national science-based initiative that armed hospital staff with time-tested tools to reduce hospital mortality rates.

The campaign included measurable goals and a specific deadline. The aim was to use proven best practices to reduce potentially preventable deaths. By the time the 18-month campaign ended in June 2006, 3,100 hospitals, including 65 of Virginia's 93 acute-care hospitals, had submitted quarterly data on compliance with six precise interventions. The results were unprecedented. After mountains of data were analyzed by the Institute for Healthcare Improvement (IHI), the final scorecard exceeded our most optimistic expectations: 122,000 lives saved nationwide.

Gratifying as it was to achieve such gains, all of us in the health-care field know more work remains. As a physician and president of Virginians Improving Patient Care & Safety (VIPC&S), I've seen from close range the tragic impact that adverse events and injuries can have on patients and their families. For all our progress, we must do more to protect patients from harm.

That's the mindset and mantra behind the next phase in our pursuit of excellence -- the 5 Million Lives Campaign. Launched in December by the IHI, this latest venture extends its focus beyond fatal injuries to include all incidents of medical harm. We hope to build on past success by introducing six additional interventions that are remarkably effective when religiously followed.

THE NEED for improvement is clear. Roughly 15 million episodes of medical harm plague U.S. hospitals each year, according to current studies of hospital injury the IHI examined. Research indicates that for every 100 hospital admissions, 40 to 50 harmful incidents occur. With 37 million U.S. hospital admissions annually (according to the American Hospital Association's 2005 National Hospital Survey), this translates to 40,000 incidents of harm each day.

Hospital leaders are eager to embrace practices to reduce that toll. Already, 67 million Virginia hospitals have enrolled in the 5 Million Lives campaign. Nationwide, nearly 3,400 hospitals have signed up, just 600 short of the goal of 4,000 by Dec. 9, 2008.

VIPC&S has long been a statewide leader in patient safety, and during our seventh annual conference in Richmond tomorrow, we'll detail improvements and discuss ways to achieve additional breakthroughs. One keynote speaker, Thomas W. Nolan, a senior fellow at IHI and one of the principal architects of the 5 Million Lives campaign, will share his insights and ideas for making hospitals safer than ever before.

To attack the most common sources of hospital harm, the 100,000 Lives campaign targeted six bundles of procedures. Adverse drug events were prevented by implementing precise medication reconciliation; deaths from heart attack were reduced by using evidence-based care for acute myocardial infarction; rapid response teams were deployed at the first sign of patient decline; a series of interdependent steps curbed ventilator-associated pneumonia and central line infections; and surgical site infections dropped with delivery of the correct perioperative antibiotics at the proper time.

SIX NEW interventions targeted by the 5 Million Lives campaign outline more opportunities to dramatically reduce injury. They include preventing harm from "high-alert" medications (those that bear a heightened risk of causing harm when used in error) such as insulin, anticoagulants, sedatives, and narcotics; reducing surgical complications by implementing each change in care recommended by SCIP (the Surgical Care Improvement Project); preventing pressure ulcers through science-based procedures; reducing methicillan-resistant staph infections by using proven infection control practices; and avoiding readmissions for congestive heart failure through evidence- based care. Last -- and perhaps most important -- the campaign seeks to get hospital boards on board so they can more effectively accelerate progress at their own facilities.

Hospitals have every incentive to add these efforts to their existing patient safety initiatives. There is no cost to join the campaign -- only an obligation to adopt at least one intervention and regularly report hospital profile and mortality data.

Elevating standards of care will take a team effort. By making proven improvements a part of everyday practice, medicine will come closer to achieving its bedrock principle: First, do no harm.

Gary Yates, M.D., is president of Virginians Improving Patient Care & Safety, based in Richmond.  He is chief medical officer for Sentara Healthcare, which operates seven hospitals in Virginia.