The 100k Lives Campaign: Getting Started

1. The 100k Lives Campaign: Getting Started Institute for Healthcare Improvement (Content for slides provided by IHI and Washington Network) 6/9/2005

2. Campaign Objective To save 100,000 lives nationally through the introduction of six proven health care improvement interventions over 18 months (end date of June 14, 2006).

3. All Washington Hospitals Participating On June 1, 2005 all community hospitals in the state of Washington committed to participating in the 100k Lives Campaign.

4. Washington Network Members Partnering toSupport Hospitals Implement Interventions • Leo Greenawalt, CEO Washington State Hospital Association • Judy Huntington, Executive Director Washington State Nurses Association • Tom Curry, CEO Washington State Medical Association • Karen Herrick, Executive Director Northwest Organization of Nurse Executives • Jonathan Sugarman, MD, MPH CEO, Qualis Health

5. Six Changes That Save Lives • Deployment of Rapid Response Teams • Improved Care for Acute Myocardial Infarction • Adverse Drug Event Prevention • Central Line Bloodstream Infection Prevention • Surgical Site Infections Prevention • Ventilator-Associated Pneumonia Prevention

6. Rapid Response Teams • A Rapid Response Team may be summoned at any time by anyone in the hospital to assist in the care of a patient who appears acutely ill, before the patient has a cardiac arrest or other adverse event. • No prior permission is required to call the Rapid Response Team.

7. Reducing Acute Myocardial Infarction Mortality • Early administration of aspirin • Aspirin at discharge • Early administration of a beta-blocker • Beta-blocker at discharge • ACE-inhibitor or angiotensin receptor blocker (ARB) at discharge (if systolic dysfunction) • Timely reperfusion • Smoking cessation counseling

8. Adverse Drug Event Prevention • Medication reconciliation ensuring that patients receive all intended medications and no unintended medications as patients move between care locations. Such as at the time of: • Admission • Unit Transfers • Discharge

9. Central Line Infection Prevention Central line bundle: • Hand hygiene • Maximal barrier precautions • Chlorhexidine skin antisepsis • Appropriate catheter site and administration system care • No routine replacement

10. Preventing Surgical Site Infections Surgical Site Infection Bundle • Guideline-based use of prophylactic perioperative antibiotics – choice and timing • Appropriate hair removal (avoiding shaving) • Perioperative glucose control

11. Ventilator Associated Pneumonia Prevention Ventilator Bundle: • Elevate head of the bed to 30-45 degrees • Daily “sedation vacations” • Daily assessment of readiness to extubate • Peptic ulcer prophylaxis • Deep venous thrombosis prophylaxis

12. Use of the Data • IHI will collect mortality data quarterly from participating organizations. • Individual hospital data will not be released to the public or any other organization (data will only be shared in aggregate). • A national comparative database which identifies each participant will not be developed.

13. Use of the Data • Number of “Lives Saved” based on changes in mortality (in-hospital deaths and discharges) within each campaign hospital, adjusting for historical trends in mortality • IHI will generate Hospital Standardized Mortality Ratios (HSMRs), a risk-adjusted mortality measure based on Medicare data, for both campaign and non-campaign hospitals, which will be used for internal analysis

14. Support • IHI provides extensive materials from national experts http://www.ihi.org/ihi. • Network provides local experts to answer technical and clinical questions. • Network facilitates the sharing of effective strategies between hospitals in Washington. • Network offering resources to speak with your medical staff, Board or other stakeholders.

15. Washington Networks Primary Contacts Carol Wagner, RN, MBA Director of Patient Safety at WSHA (206)577-1831 Rosa Johnson, ARNP, MN, CPHQ Director WA Medicare Operations at Qualis Health (206)364-9700, ext 2142 or (800)949-7536