What Zero Looks Like: Eliminating Hospital-Acquired Infections
IHI (Institute for Healthcare Improvement)
follow link to article below, some points from it:
1.7 million hospital patients ― 4.5 of every 100 admissions ― become infected each year, causing or contributing to the deaths of nearly 100,000 people.
Beginning in 2005 with its initial 100,000 Lives Campaign and now 5 Million Lives Campaign, and with the help of several scientific partners, the Institute for Healthcare Improvement has targeted for prevention and reduction 3 HAIs:
1) ventilator-associated pneumonia (VAP),
2) central line-related bloodstream infection (CLRBI), and
3) surgical site infection (SSI)
― which, according to the CDC, account for an estimated 50% of all HAI-related deaths.
Joe McCannon, manager of the 5 Million Lives Campaign, and an IHI vice president
Hospitals participating in the Campaign significantly reduced their monthly HAI rates, in some months all the way down to zero, and “a surprising number were getting down to zero and staying there.”
FOR CHANGE TO STICK, AN ORGANIZATION HAS TO REVAMP ITS CULTURE as well as its procedures.
not just zero infections but zero tolerance for non-compliance with proven prevention measures
When you’re talking about something that can cost people their lives and zero is possible, no other benchmark makes sense.
“We dug into the details and found that, officially, good processes were in place but they had broken down or, in some places, were being ignored.” Staff re-education and greater accountability were part of the remedy but the hospital also decided to post large charts in the corridor of the operating rooms, tracking monthly SSIs with big black dots. “That helped keep all staff and physicians aware of our need to improve,”
“We don’t blame anyone, we look for poorly designed processes and try to fix them”
After much work on “culture and transparency, we now have nurses admitting to short-cuts and violating policies ― and they tell us why.”
the rate of deep chest surgical site infections following CABGs got down to zero and with some exceptions, has remained at zero for multiple months at a time ― the longest was a 15-month stretch
hospital has been able to reduce its rate of ventilator-associated pneumonia ― an infection that enters the body via a mechanical breathing tube ― to zero, sustaining that level for as long as two years.
overall infection rate was reduced from 3.6 cases per 1,000 patient days before the intervention to 0.85 cases
it’s reasonable to expect that zero infections will become a widely-accepted goal for hospital performance.
"People want to do the right thing.