Helping make hospitals safer: Patient safety campaign gets it right

One preventable medical error is one too many. But even in our nation's high-caliber health system, mistakes do occur. Recognizing that, the American Medical Association has dedicated itself to many programs and initiatives aimed at improving quality.

One of the latest is the Institute for Healthcare Improvement's "100k Lives Campaign." The AMA is a partner in this effort alongside other leading private- and public-sector health care organizations.

The plan is ambitious: Enlist 1,500 to 2,000 hospitals to reduce the number of unintended deaths by 100,000 over the course of 18 months, ending in June 2006, and maintain this progress each year thereafter. The facilities would accomplish this by implementing some or all of six best practices proven to reduce patient harm and death.

These interventions are: Deploying rapid-response teams at the first sign of patient decline; delivering evidence-based care for patients with acute myocardial infarction; implementing medication reconciliation -- listing and evaluating all of a patient's drugs to prevent adverse events; and using science-based methods to prevent central line infections, ventilator-associated pneumonia and surgical site infections.

Participating hospitals agree to measure their results with monthly mortality data reported on a quarterly basis. Their findings will be made public in the aggregate.

The initiative attacks the problem in the best of ways -- by focusing on system improvements based on evidence. It does not rely on the blame-and-shame mentality that is so detrimental to patient safety and quality improvement.

On the surface, the program is hospital focused. But doctors have a crucial role to play. How? A good start is to encourage their hospital leaders to join the effort. At hospitals that already have embraced the initiative, physicians can participate by helping to implement the quality improvement steps.

All of the recommended actions require a team effort -- doctors working with nurses and other personnel as a force for change. This is an opportunity for doctors to lead.

The AMA is throwing its support behind the program by using its communication and education resources to get doctors involved.

The initiative is a serious effort striving for concrete results. The institute is well on its way, having already signed up more than 1,000 hospitals. Such heavy hitters as the Dept. of Veterans Affairs and HCA have joined. Partners include not only the AMA but also the Joint Commission on Accreditation of Healthcare Organizations and the Centers for Medicare & Medicaid Services.

The AMA's participation is part of a continuum of its patient safety efforts. Others include Council on Scientific Affairs activities, support of the National Patient Safety Foundation, promotion of health literacy, the convening of the Physician Consortium for Performance Improvement, and advocacy for federal legislation to create a voluntary, confidential medical error reporting system.

The promise of the 100k Lives Campaign lies in its drive to make error prevention part of everyday practice. As AMA President John C. Nelson, MD, MPH, said in announcing the Association's support: "Saving lives and helping patients is why most physicians choose to enter medicine in the first place."

This effort gives them the tools to do so, with a quantified goal that underscores the seriousness of the campaign's mission and its scope.