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The 100,000 Lives Campaign: Six Months In…

The 100,000 Lives Campaign: Six Months In…. Donald M. Berwick, MD, MPP Institute for Healthcare Improvement 1 st Annual Summit on Redesigning Hospital Care San Diego, CA: June 9, 2005 www.ihi.org. IHI’s “No Needless” List. No needless deaths No needless pain No helplessness

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The 100,000 Lives Campaign: Six Months In…

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  1. The 100,000 Lives Campaign: Six Months In… Donald M. Berwick, MD, MPP Institute for Healthcare Improvement 1st Annual Summit on Redesigning Hospital Care San Diego, CA: June 9, 2005 www.ihi.org

  2. IHI’s “No Needless” List No needless deaths No needless pain No helplessness No unwanted waiting No waste …for anyone

  3. The latest large study… • McGlynn, et al: The quality of health care delivered to adults in the United States. NEJM 2003; 348: 2635-2645 (June 26, 2003) • 439 indicators of clinical quality of care • 30 acute and chronic conditions, plus prevention • Medical records for 6712 patients • Participants received 54.9% of scientifically indicated care (Acute: 53.5%; Chronic: 56.1%; Preventive: 54.9%) Conclusion: The “Defect Rate” in the technical quality of American health care is approximately 45%

  4. Core Conclusions • There are serious problems in quality • Between the health care we have and the care we could have lies not just a gap but a chasm. • The problems come from poor systems…not bad people • In its current form, habits, and environment, American health care is incapable of providing the public with the quality health care it expects and deserves. • We can fix it… but it will require changes

  5. Campaign Objectives • Save 100,000 Lives • Enroll more than 2,000 hospitals in the initiative • Build a reusable national infrastructure for change

  6. Key Campaign Principles • “Some is not a number; soon is not a time.” • Welcome anyone at any level. • We do this together.

  7. Six Changes That Save Lives • Deploy Rapid Response Teams • Deliver Reliable, Evidence-Based Care for Acute Myocardial Infarction (Heart Attacks) • Prevent Adverse Drug Events (ADEs) • Prevent Central Line Infections • Prevent Surgical Site Infections • Prevent Ventilator-Associated Pneumonia

  8. Baptist-DeSoto HSMR(Hospital Standardized Mortality Rate)

  9. Campaign Status • Over 2,200 hospitals enrolled in all 50 states • Nearly 50% of U.S. hospital beds • Thousands on national calls • Unprecedented web activity and new tool development • Related campaigns forming globally • Data collection underway with Pioneer Group; begins for all enrollees on June 14, 2005

  10. Extraordinary Support • Over 35 “nodes” and counting • Vibrant partnerships (AAMC, AHRQ, AMA, AHQA, ANA, Ascension, CMS, CDC, JCAHO, Leapfrog, NPSF, NRHA, NC State Hosp. Assoc., Premier, Qualis, SSM, UHC, VA, VHA) • Generous financial backing (BCBS of MA, Moore Foundation, Leeds Family, Rx Foundation, Blue Shield of CA Foundation, Colorado Trust, Cardinal Health Foundation)

  11. Campaign Participants So Far (a sample…) • American Medical Association, American Nurses Association, American College of Physician Executives, Association of American Medical Colleges, JCAHO, Leapfrog Group, NPSF, Premier, University HealthSystem Consortium, VHA • Leading systems: SSM Health Care, Ascension Health, Hospital Corporation of America, Tenet Health Care • State Hospital and Nurses Associations: MA, NC, IL, MI, WA…. • Federal Agencies: CMS, CDC, AHRQ, VA • Scientific Societies: ACC, American Heart Association, APIC, SCCM, SHEA, SGIM • Pediatric (NICHQ, NACHRI, CHCA) and rural (NRHA) “nodes” • AHQA (Quality Improvement Organizations) • Financial support: BCBS of MA, Moore Foundation, Leeds Family, Rx Foundation, Blue Shield of CA Foundation, Colorado Trust, Cardinal Health Foundation ……… Over 2,200 hospitals so far…… And counting……

  12. Getting Down to Work • Enrollment is exciting but insufficient on its own. Let’s seize the opportunity we’ve created • We need to introduce these interventions reliably in every participating hospital by engaging leaders, front line providers, patients, and families • All Campaign stakeholders – IHI, partners, nodes, hospitals – have to pull together to support implementation • Start with small steps within your organization (use the new guide to hospital-wide Campaign activity available on www.ihi.org today)

  13. Campaign Timeline

  14. Supports and Events • New Campaign “Progress” page of www.ihi.org launches today • Campaign-wide data submission begins June 14 (Preparatory National Call June 13; see Campaign website for details) • June 23 National Call on implementation strategies • Nationwide Summer Tour…the Campaign is coming to a city near you • Round Two of National Calls on each intervention this July • “100K LIVE!” call-in shows begin in July

  15. Implementation: Individual Hospitals • Plan for the involvement of several different groups within your organizations: • The front line providers of care • The Board • The leadership team • All staff • Patients and families • Community groups • Make the Campaign your own

  16. Implementation: Individual Hospitals • How to jump start the Campaign: • Select your interventions • Build your teams • Hold a rally • Listen to national calls (and recordings) • Review Campaign materials (including schedule, forthcoming check lists and assessment tools) • Learn more about improvement • Create a work plan

  17. Look…. This Is Not Going to Be Easy! • Technical changes and cultural changes • Reliability of “bundles” – composites – no “partial credit” • Automation, standing orders, default systems • Teamwork • Valuing initiative… from everyone (nurses, pharmacists, all..) • Pretend the goal is 3 months away, not 12 months away – audit in July, 2005 • Are the process changes being made? – Really? • Are deaths decreasing? – Really? • Revisit and redesign implementation accordingly … by September 1, 2005 • Fail First – Learn – Then Succeed • Use the whole Campaign system. You are part of something very big, ambitious, and wonderful. Use It!

  18. REALLY? • “We are already doing the six changes.” • REALLY? • “Our care for (heart attacks, surgical sites, central lines, ventilator patients, medication reconciliation) is highly reliable? • REALLY? • “Our nurses are empowered to act when they get worried, and to get support immediately and without criticism.” • REALLY? • “We are connected to the Campaign community, and learning from it every day.” • REALLY? • “We are saving lives now that we would not have before.” • REALLY?

  19. THE Question for the Next Three Months REALLY?

  20. For more information... www.ihi.org/campaign

  21. Some Is Not a Number… Soon Is Not a Time The Number: 100,000 Lives The Time: June 14, 2006 – 9 a.m. ET

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