Hospitals beat "100,000 Lives" goal by 22,300

Chicago -- It was "with some trepidation" that Donald M. Berwick, MD, called John C. Nelson, MD, MPH, then AMA president, to ask for the Association's aid with a plan to help hospitals prevent 100,000 avoidable patient deaths.

"I didn't know how the organization would respond," Dr. Berwick, president and CEO of the Institute for Healthcare Improvement, told the House of Delegates at its Annual Meeting last month. "But they have been right there with us all along."

In the end, the IHI-led 100,000 Lives Campaign wound up enrolling more than 3,000 hospitals, accounting for 75% of U.S. hospital beds. The 18-month-long initiative to help hospitals implement six different evidence-based, life-saving interventions surpassed its goal by 22,300 lives.

The campaign came to its lives-saved figure by using pre-campaign mortality figures for each hospital for an expected number of deaths. The raw mortality figures were adjusted for severity and case mix by three outside firms, with lives-saved estimates ranging from 115,000 to 149,000.

"This campaign brought much-needed energy and attention to patient safety," said Modena Wilson, MD, MPH, AMA senior vice president of professional standards.

In the effort to save lives, participating hospitals committed to activating rapid-response teams at the first sign of patient deterioration; giving aspirin and beta-blockers to heart attack patients; and preventing medication errors, surgical infections, ventilator-associated pneumonia and central-line infections. The AMA created and distributed thousands of tool kits designed to help physicians implement changes in their hospitals.

Lessons learned during the 18-month initiative could help as other patient-safety campaigns are waged. The 100,000 Lives Campaign fostered a system of 50 health care nodes to help hospitals implement changes, representing a "reusable infrastructure" to pursue other patient-safety improvements, Dr. Berwick said. Possible targets include hospital-acquired sepsis, pain management and chronic illness care. IHI expects to announce plans at its national forum in December.