OSF Saint James - John W. Albrecht Medical Center

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Overview of the 5 Million Lives Campaign

Do No Harm. It is a fundamental principle for health care providers: primum non nocere – first, do no harm. It is our duty, our responsibility. Patients ask and assume that the health care that intends to help them should, at the very least, not injure them.

Despite the extraordinary hard work and best intentions of caregivers, thousands of patients are harmed in US hospitals every day. Hospital-acquired infections, adverse drug events, surgical errors, pressure sores, and other complications are commonplace.

Based on data collected over several years from multiple partner institutions, The Institute for Health Improvement (IHI) estimates that nearly 15 million instances of medical harm occur in the US each year – a rate of over 40,000 per day. This is a burden larger than most patients and professionals, and even some health care researchers, realize.

It is time to declare this toll unacceptable; time to end it. You can help.

An Impressive Start

When IHI and its partner organizations came together to launch the 100,000 Lives Campaign, a national effort to reduce preventable deaths in US hospitals, no one could have imagined the strength of the response. What happened was truly exhilarating: an extraordinary resurgence of spirit and an unprecedented commitment to change and collaboration across the health care industry.

The 3,100 hospitals that participated in this initiative achieved a remarkable goal. Through their work on the Campaign’s interventions, combined with other national and local improvement efforts, these facilities saved an estimated 122,000 lives in 18 months. Along the way, nothing less than new standards of care began to emerge. Health care will never be the same – and the work continues.

An Expanded Focus

Avoidable deaths are the most extreme consequence of defects in health care, but harm is another important foe – and one that tragically affects many more lives. Many harm events have lasting effects on the lives of patients and their loved ones.

For this reason, IHI and its partner organizations are going to tackle medically-induced injuries in health care. We will expand our focus in a new campaign designed to dramatically accelerate efforts to reduce non-fatal harm, while continuing to fight needless deaths.

There are many other patient safety initiatives underway that align with these objectives. As IHI launches this next Campaign, we intend to coordinate and collaborate with these other superb efforts to amplify all programs and achieve unprecedented national results.

Five Million Lives

IHI believes the time is right to establish another bold objective – a seemingly impossible goal – for US health care:

Protect patients from five million incidents of medical harm over the next two years (December 2006 – December 2008)

To achieve this, we aim to enlist at least 4,000 US hospitals in a renewed national commitment to improve patient safety faster than ever before.

Proven Interventions

The 5 Million Lives Campaign challenges American hospitals to adopt 12 changes in care that save lives and reduce patient injuries:

The six interventions from the 100,000 Lives Campaign:

Deploy Rapid Response Teams…at the first sign of patient decline

Deliver Reliable, Evidence-Based Care for Acute Myocardial Infarction…to prevent deaths from heart attack

Prevent Adverse Drug Events (ADEs)…by implementing medication reconciliation

Prevent Central Line Infections…by implementing a series of interdependent, scientifically grounded steps

Prevent Surgical Site Infections…by reliably delivering the correct perioperative antibiotics at the proper time

Prevent Ventilator-Associated Pneumonia…by implementing a series of interdependent, scientifically grounded steps

New interventions targeted at harm:

Prevent Harm from High-Alert Medications... starting with a focus on anticoagulants, sedatives, narcotics, and insulin

Reduce Surgical Complications... by reliably implementing all of the changes in care recommended by SCIP, the Surgical Care Improvement Project (www.medqic.org/scip)

Prevent Pressure Ulcers... by reliably using science-based guidelines for their prevention

Reduce Methicillin-Resistant Staphylococcus aureus (MRSA) infection…by reliably implementing scientifically proven infection control practices

Deliver Reliable, Evidence-Based Care for Congestive Heart Failure... to avoid readmissions

Get Boards on Board … by defining and spreading the best-known leveraged processes for hospital Boards of Directors, so that they can become far more effective in accelerating organizational progress toward safe care

For more information about the Campaign interventions, including How-to Guides for each, see the Materials area of IHI.org at:
http://www.ihi.org/IHI/Programs/Campaign/Campaign.htm?TabId=2.

OSF Saint James Joins IHI's Effort Effort To Save Lives

OSF Saint James – John W. Albrecht Medical Center was a charter participant in the Institute for Healthcare Improvement’s 100,000 Lives Campaign, the first-ever national campaign to save 100,000 lives by implementing proven healthcare improvement techniques.

The campaign was formally unveiled on December 14, 2004, and was endorsed by such distinguished healthcare organizations as the American Medical Association, the American Nurses Association, the Centers for Medicare & Medicaid Services and the Joint Commission on Accreditation of Healthcare Organizations. A theme, "Some is not a number and soon is not a time," was the rallying cry to give the campaign definite numeric and time frame goals. (With the success of the 100,000 Lives Campaign, the IHI followed up with a second campaign, committed to protecting 5 million lives from harm while undergoing medical care. OSF Saint James is a participant in that campaign, as well.)

Believing whole-heartedly that it is the right thing to do for our patients, our staff members and the communities we serve, OSF Saint James is dedicated to providing consistent, high quality care. We have programs in place that address the six recommendations made by the IHI’s campaigns (listed below). However, we are continually seeking ways to raise the bar and improve care.

OSF HealthCare representatives worked with the IHI to shape the campaign’s recommendations for improving patient care. Those recommendations are:

Deploy Rapid Response Teams—by allowing any staff member, regardless of position in the chain of command, to call upon a specialty team to examine a patient at the first sign of decline instead of waiting for a code situation.

OSF Saint James has its Rapid Response Team (RRT) in place and operating. The team, which is available 24 hours a day, is composed of a registered nurse from the medical center's critical care unit, a respiratory therapist, and a member of the Pastoral Care Team. In 2007, OSF Saint James added the ability for patients and family members to initiate the Rapid Response Team.

Deliver Reliable Evidence-Based Care for Acute Myocardial Infarction (heart attack)—by consistently delivering key measures - including early administration of aspirin and beta-blockers – that prevent patient deaths from heart attack.

OSF Saint James currently meets national averages in delivering these medications to patients. Data is available on the Quality Improvements main page of this website.

Prevent Adverse Drug Events—by implementing medication reconciliation, which requires that a list of all of a patient’s medications (even for unrelated illnesses) be compiled and reconciled to ensure that the patient is given (or prescribed) the right medications at the correct dosages—at admission, discharge and before transferring to another care unit.

For the past two years, OSF Saint James has been reconciling patient medications upon admission and when transferring to a new unit and at discharge. Work continues on the implementation of a direct order system that will further increase the reliability of medication systems and includes all clinical points of contact at the medical center.

Prevent Central Line Infections—by consistently delivering five interdependent, scientifically grounded steps collectively called the “Central Line Bundle.”

OSF Saint James is in the development phase of enhancing our program to prevent these infections. The medical center's central line infection rate has been low and some measures are in place but work to standardize these efforts is continuing.

Prevent Surgical Site Infections—by reliably delivering the correct antibiotics before, during and after surgery, as well as maintaining glucose levels and avoiding shaving hair at the surgical site.

Prevent Ventilator-Associated Pneumonia—by implementing five interdependent, scientifically grounded steps collectively called the “Ventilator Bundle” – such as elevating the head of the hospital bed by 30 degrees – thereby dramatically reducing mortality and length of stay in the Intensive Care Unit.

"We are organizing a world-class campaign to elect quality,” said Dr. Donald Berwick, President and CEO of the Institute for Healthcare Improvement (IHI). “The health care organizations that join this campaign are not only demonstrating their commitment to improvement but their determination to put proven, life-saving improvement techniques into action.”

To learn more about the 5 Million Lives Campaign, go to www.ihi.org/ihi/programs/campaign.

The Institute for Healthcare Improvement (IHI) is a not-for-profit organization leading the improvement of health care throughout the world. Founded in 1991 and based in Cambridge, MA, IHI is a catalyst for change, cultivating innovative concepts for improving patient care and implementing programs for putting those ideas into action. Thousands of health care providers, including many of the finest hospitals in the world, participate in IHI’s groundbreaking work.