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Ambitious effort aims to save 100,000 lives

With six steps, a sleek campaign asks hospitals to make patient safety a top priority, and bay area hospitals are signing up to meet the deadline.

By LISA GREENE
Published April 18, 2005

Suppose an elderly woman goes into Morton Plant Hospital with a bad case of the flu. She's feverish and tired, but expected to recover.

Instead, the woman gets sicker. Her heart quickens, her blood pressure drops. She could be developing pneumonia or an infection, problems that often kill elderly flu patients.

Of course, doctors hope the hospital's medical staff would quickly notice and treat such symptoms. But to make sure, the hospital today will start a new "rapid response team" designed to increase the odds that failing patients get help before it's too late.

The hospital is one of several in the Tampa Bay area that joined an ambitious national effort, the 100,000 Lives Campaign, to make patients safer.

Over the past few years, doctors have been paying more attention to the fact that hospitals don't always improve their patients' health.

In fact, they may kill them - with surgical mistakes, the wrong drugs or doses or infections. Medical mistakes kill between 44,000 and 98,000 patients each year, says a landmark 1999 federal report that prompted a wave of concern for patient safety.

But keeping the drive for patient safety a top priority isn't easy. Safety measures can sound technical to the public and be costly and time-consuming for hospitals.

Enter the 100,000 Lives Campaign, with one goal and a deadline. Its aim: save 100,000 lives by June 14, 2006. At 9 a.m.

"I think it is hard for people to understand how much better their care could be," said the campaign's founder, Dr. Donald Berwick. "We have to find a way to make this concrete for the public at large. ... I don't want them to be angry at their doctors, I just want them to expect their health care system to do far more than it does today."

Berwick, a clinical professor at Harvard Medical School, is president and CEO of the Institute for Healthcare Improvement, a nonprofit group. He is a member of the governing council of the Institute of Medicine and was a member of the committee that wrote the influential medical errors report.

Berwick launched the campaign after talking with staff members and his son, who was working last fall on a political campaign. Berwick was intrigued, and modeled the plan as a campaign, complete with deadline, grass roots buy-in and catchy name.

On Dec. 14 at 9 a.m. at the institute's annual meeting in Orlando, Berwick unveiled the plan, with its deadline set for precisely 18 months later. More than 400 hospitals signed up then and there. By last week, 1,800 hospitals had joined.

"He's a very inspiring speaker," said Judi Vitucci, administrative director of outcomes at All Children's Hospital in St. Petersburg. "He's kind of like the Pied Piper. We're following him, because he really is doing it right."

Vitucci and other All Children's employees got approval to enroll their hospital within a few weeks. The BayCare hospitals - Morton Plant, St. Joseph's, St. Anthony's, North Bay, and South Florida Baptist, as well as Morton Plant's partners, Mease Dunedin and Mease Countryside - have signed on.

At least two federal agencies, the American Medical Association, and several state hospital groups have endorsed the effort as well.

The campaign asks hospitals who enroll to take six steps to improve safety, including starting the rapid response teams, preventing infections and improving care for heart attacks. The hospitals submit monthly reports on patient deaths, so the campaign can track whether death rates are falling. That data will show whether 100,000 lives are saved.

"This is the right thing to do for our patients," said Cindy Rider, director of clinical outcomes for BayCare Health Systems.

Rider, Vitucci and Dr. Roger Ray, chief medical officer at Morton Plant Mease Health Care, said their hospitals already are working on, or have implemented, recommended safety changes. But the campaign's suggestions and frequent conference calls provide information and a chance to hear how other hospitals are making changes, they said.

"For one of the first times in the nation, to have that degree of collaboration between multiple sites, with very specific, evidence-based interventions, and measuring the same way at the same time - it's a really phenomenal opportunity," said Vitucci of All Children's, which decided two of the six measures would work in pediatrics.

"The campaign is about really trying to create enough awareness and enthusiasm that what people would get to eventually gets done a little faster," Ray said.

The rapid response team, which rolls out today at Morton Plant is similar to hospital "code blue" teams that respond when a patient's heart stops - but would be summoned much earlier, by any staffer who thinks a patient needs extra help.

"When you sense things (with a patient) are more fragile, this is a more methodical way to intervene," Ray said. Despite the response, it's too soon to see whether the campaign will reach its goal. Berwick says he's not worried.

"We'll uncork champagne for 20,000 lives," he said. "If we don't (meet the goal), we're still going to learn. There's so much improvement we need in health care."

[Last modified April 18, 2005, 00:52:13]