Health Care Issues

Saving 100,000 Lives: Revisited

Nearly one year ago, I explained the initiation of a national campaign, “Saving 100,000 Lives,” developed by the Institute for Healthcare Improvement. Donald Berwick, MD, president and CEO of IHI, announced in December 2004 that the goal of the campaign was to save 100,000 lives by June 14, 2006. So, one year later, what’s been the progress?

When the campaign began, about 500 hospitals were early committers, including all six hospitals in the OSF Healthcare System. Since then, more than 2,500 hospitals have joined this worthwhile effort, including Methodist Medical Center. These 3,000 hospitals account for 90 percent of all patients discharged in the U.S. each year, so with this high participation rate, there certainly is the potential to accomplish the goal of preventing the deaths of 100,000 patients. In its December 2005 Progress Report, IHI contended that “never before have we seen such unity in our industry around a shared purpose, the common cause of avoiding preventable deaths.”

Secondly, the campaign detailed six changes in care that have been proven to prevent avoidable deaths. Both Methodist Medical Center and OSF Saint Francis Medical Center are participating in these initiatives. Of the 3,000 hospitals participating, here are the percentages tackling each one:
• 59 percent, rapid response teams.
• 77 percent, improved care for acute myocardial infarction.
• 73 percent, prevention of adverse drug events.
• 65 percent, prevention of central line-associated bloodstream infection.
• 72 percent, prevention of surgical site infection.
• 67 percent, prevention of ventilator-associated pneumonia (VAP).

Finally, lives have been saved. As of February 1, 33,460 lives have been saved throughout the U.S. The IHI has two methods of projecting how many lives will be saved by the end of the campaign on June 14. The first is a linear projection that estimates there will be 48,581 lives saved. But because of the many lessons learned and the start-up time to really establish these initiatives, the IHI also has a second projection based upon an accelerated extrapolation: 98,094. Momentum is building among the 3,000-plus participating hospitals, as evidenced by 74 percent of us regularly submitting data; a record crowd of 5,000-plus persons from the participating hospitals attended IHI’s national conference in December; and many hospitals have reported outstanding results, such as OSF St. Mary Medical Center in Galesburg recording its 20th month in a row with no VAP cases. OSF Saint Francis reported significant improvements in the prevention of VAP and central line-associated bloodstream infections during the past two years.

As Berwick originally put it, “Soon is not a time, some is not a number. Establishing specific targets—100,000 lives in 18 months—helps to put a human face on the effort.” Much work still needs to be done to reach this campaign goal, but the momentum that’s built will carry us beyond the June 14 deadline, which ultimately will benefit many patients and their families. The leaders of our area hospitals are committed to doing so. IBI