Impatient with the healthcare industry's efforts to weed out medical mistakes, a Boston quality expert launched an 18-month campaign last week to enlist 1,600 hospitals to reduce preventable medication mistakes and harmful errors related to heart disease, surgery or ventilator patients.
Donald Berwick, president and chief executive officer of the Institute for Healthcare Improvement, estimated that the effort may prevent as many as 100,000 avoidable deaths annually. While the American Medical Association, the CMS and the Joint Commission on Accreditation of Healthcare Organizations joined the effort, notably absent was the American Hospital Association, which nevertheless praised the IHI's goals.
"It is possible to have a dramatic impact on outcomes," said David Pryor, senior vice president of clinical excellence at Ascension Health, St. Louis. Ascension cut infections among dangerously vulnerable patients at its hospitals in Birmingham, Ala., and Detroit by emphasizing hand-washing in intensive-care units and properly elevating the head of ventilator patients, among other additional measures, Pryor said. Though its quality-improvement efforts began before the IHI's campaign, Ascension, the nation's largest Catholic hospital system, said it would participate (Nov. 1, p. 28).
In addition to preventing central line infections and ventilator-associated pneumonia, the campaign sets out steps to form rapid response teams for critically ill patients, prevent adverse drug events, improve care for heart attack victims and prevent surgical infections. "Everybody can do this," Pryor said.
In fact, hospitals can and already do perform safety and quality-improvement strategies outlined in the IHI's campaign, said Don Nielsen, senior vice president of quality leadership at the AHA.
The AHA, which represents nearly 5,000 hospitals, health systems and medical providers, turned down Berwick's invitation to join the campaign and decided instead to focus on similar, existing efforts, Nielsen said, citing the National Hospital Quality Alliance as an example. The alliance is an effort by a dozen federal agencies, national associations and quality groups to publicly report quality data.
"We've just elected to remain focused," Nielsen said. "We're working with our members in a similar fashion to improve care for patients."
Jonathan Small, an IHI spokesman, said organizers expected as many as 500 hospitals would sign on to the IHI's effort in its first few days. To enroll, hospitals must publicly pledge to adopt one or more of the half-dozen safety improvements.