The 100K Lives campaign has taken to the streets.
Halfway through the 18-month effort to improve the quality of care in the nation's hospitals and save patients' lives, the Boston-based Institute for Healthcare Improvement rolled out a dressed up, 30-foot recreational vehicle, loaded it with IHI staffers and hospital officials and embarked on a 15-stop, coast-to-coast tour.
More than 2,700 U.S. hospitals have enrolled in the campaign and pledged to adopt at least one of six quality-improvement "interventions," says Joe McCannon, the campaign's director, who will be riding most of the way from the tour's start Sept. 27 in Boston to its end in Seattle on Oct. 14.
Destinations along the way include several of 47 "regional nodes," typically rallying points within a state where campaign organizers have worked with local participants to establish communication, support and learning centers, part of what McCannon says will be a lasting, "national infrastructure for change."
The IHI odyssey aims to publicize the campaign and "rally participating hospitals for the second half," McCannon says. Another goal is for IHI staffers "to get out into the field to learn as much as we can."
After the trip, he says, "We'll sit down and see about making adjustments to better support the hospitals."
The quality-improvement targets include establishing in-hospital emergency-response teams, improving heart attack care and creating programs to prevent medical errors, central-line infections, surgical infections and pneumonia among patients on ventilators.
Based on the average size of hospitals enrolling, McCannon estimates that the participating facilities have more than half of the hospital beds in the U.S., and anywhere between a third and a half of enrolled hospitals have committed to doing all six interventions, with improvements in heart attack care the most commonly selected program.
Hospitals continue to sign up for the program-to a degree that IHI might need a boat for its next campaign. "We've had inquiries as well from the U.K. and Australia," McCannon says.
David Cox appears to be worried about his legal fees going over budget.
Cox, a former chief financial officer of Fletcher Allen Health Care, has been charged with five counts of fraud for allegedly taking part in a scheme to hide the true costs of the Burlington, Vt., system's construction plan, known as the Renaissance Project.
Cox has filed a civil lawsuit requesting that the system pay for his legal fees in the case. In the lawsuit, Cox's lawyers claim the system's bylaws call for paying executives' legal expenses.
Cox left Fletcher Allen in 2001 and had been working as the CFO of St. Mary's Hospital in Waterbury, Conn. Despite being promoted to executive vice president from vice president in 2004, St. Mary's issued a news release last week announcing Daniel DeBarba as the new CFO. The release didn't mention Cox and the hospital didn't respond to calls seeking information about Cox's lawsuit.
The charges against Cox stem from allegations that he and others told the Vermont Banking, Insurance, Securities and Health Care Administration that the cost of the project would be about $178 million. The project wound up costing $380 million, according to a Fletcher Allen spokesman. (Vermont is a certificate-of-need state.)
The system's former chief executive officer, William Boettcher, has received a two-year sentence for his role in the scheme. The system's board hasn't said if Boettcher received money for his legal costs, according to the spokesman.
Cox isn't the first to ask for his former company to pay legal fees in the wake of a scandal. Richard Scrushy, the fired CEO of Birmingham, Ala.-based HealthSouth Corp., filed a lawsuit that requested the company pay for his legal costs, but the case was dismissed.
Steven Smith, a Chicago-based partner with the law firm Bryan Cave, says that it's common for companies to include provisions in their bylaws that call for paying executives' legal fees. It's also common for the companies to include language that restricts the perk, but "typically it's limited to acts that aren't intentional," he says.
Gator's gonna getcha
According to a recent study, hospitals in Southern states had better train more people to handle really big bite wounds.
As the population of alligators has rebounded from endangered-species status to more than 3 million in the U.S. and urban sprawl reaches ever farther into their swampy habitat, human-gator contact is increasing, with unpleasant outcomes, it seems.
Writing in the current issue of the journal Wilderness and Environmental Medicine, Ricky Langley, an epidemiologist with the North Carolina public health office, says that public data show that alligators caused some 376 human injuries and 15 fatalities from 1948 to Aug. 1, 2004. Since his study was conducted, Langley reports that two additional deaths have occurred from alligator attacks.
But he also believes that the incidents are undercounted. Most of the documented cases occurred in Florida, where there were 334 attacks and 14 fatalities, followed by Texas with 15 attacks, and Georgia and South Carolina with nine apiece. Langley wants a uniform system for reporting alligator attacks for the 10 states with significant gator populations.
Langley also found that the most-reported activities at the time of the attack were attempting to capture, pick up or exhibit an alligator, 17.4%; swimming, 16.7%; fishing, 9.9%; and retrieving golf balls, 9.5%.
The number of human-gator encounters is rising fast, Langley says. Reported alligator sightings in Florida increased from 5,000 in 1978 to nearly 15,000 in 1998.