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BWH last year joined the Institute for Healthcare Improvement’s 100,000 Lives campaign, which may have saved 122,342 patients’ lives across the nation.
The campaign, launched in December 2004, includes six evidence-based quality improvement measures (see inset) for participating hospitals to implement. Last week, Don Berwick, MD, president and CEO of the Cambridge-based Institute for Healthcare Improvement, visited BWH for a Quality Rounds presentation on lessons learned from the 18-month campaign, which officially ended in June.
“No academic medical center has been closer to our work than Brigham and Women’s Hospital. It’s a thrill to be here,” Berwick said in greeting a packed Bornstein Amphitheater.
BWH was one of more than 3,000 hospitals—including 95 percent of Massachusetts hospitals— to participate in the 100,000 Lives campaign.
One key to the campaign’s success in drawing so many participants was setting a deadline—June 14, 2006—for saving 100,000 patients’ lives. “‘Some is not a number, soon is not a time’ (the campaign slogan) resonates with the spirits of workers,” said Berwick, who wanted the campaign to have a sense of urgency and a definite goal.
He reported that the 122,342 lives saved since the start of the campaign are patients who left the hospital alive who would have been predicted to die in the hospital.
The number of lives saved was calculated by comparing patient mortality data at participating hospitals before and during the campaign, and adjusting those numbers for the severity of patients’ illnesses. Because the adjustments were made based on national changes in the severity of patients’ illnesses rather than on changes at participating hospitals, Berwick said there is no proof that the lives were saved because of the campaign. Participating hospitals also have implemented a number of quality improvement programs at once, making it difficult to know the campaign’s impact.
“Scholars will criticize it, and I welcome that. This is how improvement improves,” Berwick said.
In December 2005, BWH began a pilot Rapid Response Team on Tower 14, and in July 2006, put in place an electronic system to reconcile patients’ medications. Another initiative in sync with the campaign’s measures is an effort among anesthesiologists to reduce central line infections. “We realized we needed to improve our process,” said Sunil Eappen, MD, vice chair for Clinical Affairs in Anesthesiology, Perioperative and Pain Medicine. Having the anesthesiologists scrub and gown prior to placing the line and use a more extensive sterile drape reduces infections and decreases morbidity and mortality in these patients.
“This effort required collaboration between anesthesiologists, surgeons, nurses and administrators so that we can do what is best for our patients,” Eappen said.
In addition, first-year residents for the past two years have received special training in central line placement, said Elise Tamplin, infection control practitioner. “Every new resident, except for those in Dental and Psychiatry programs, have practiced insertion technique on mannequins with the supervision of senior staff to make sure they are minimizing the risk of infection.”
The 100,000 Lives Campaign includes six quality improvement measures: