Do No Harm. It is a fundamental principle for health care providers: primum non nocere – first, do no harm. It is our duty, our responsibility. Patients ask and assume that the health care that intends to help them should, at the very least, not injure them.

• Deploy Rapid Response Teams…at the first sign of patient decline
• Deliver Reliable, Evidence-Based Care for Acute Myocardial Infarction…to prevent deaths from heart attack
• Prevent Adverse Drug Events (ADEs)…by implementing medication reconciliation
• Prevent Central Line Infections…by implementing a series of interdependent, scientifically grounded steps
• Prevent Surgical Site Infections…by reliably delivering the correct perioperative antibiotics at the proper time
• Prevent Ventilator-Associated Pneumonia…by implementing a series of interdependent, scientifically grounded steps

• Prevent Harm from High-Alert Medications... starting with a focus on anticoagulants, sedatives, narcotics, and insulin
• Reduce Surgical Complications... by reliably implementing all of the changes in care recommended by SCIP, the Surgical Care Improvement Project (www.medqic.org/scip)
• Prevent Pressure Ulcers... by reliably using science-based guidelines for their prevention
• Reduce Methicillin-Resistant Staphylococcus aureus (MRSA) infection…by reliably implementing scientifically proven infection control practices
• Deliver Reliable, Evidence-Based Care for Congestive Heart Failure... to avoid readmissions
• Get Boards on Board … by defining and spreading the best-known leveraged processes for hospital Boards of Directors, so that they can become far more effective in accelerating organizational progress toward safe care

For more information about the Campaign interventions, including How-to Guides for each, see the Materials area of IHI.org at:
http://www.ihi.org/IHI/Programs/Campaign/Campaign.htm?TabId=2.

OSF Healthcare System Leads National Effort To Save 5 Million Lives

Prior to continuing with IHI's "5 Million Lives" campaign, OSF Healthcare System participated in the Institute for Healthcare Improvement’s 100,000 Lives Campaign, the first-ever national campaign to save 100,000 lives by implementing proven healthcare improvement techniques.

The campaign was formally unveiled on December 14, 2004, and was endorsed by such distinguished healthcare organizations as the American Medical Association, the American Nurses Association, the Centers for Medicare & Medicaid Services and the Joint Commission on Accreditation of Healthcare Organizations. A theme, "Some is not a number and soon is not a time," was established to give the campaign definite numeric and time frame goals. When the campaign ended in June, 2006, more than 100,000 lives had been saved.

"OSF was a full participant in the IHI's 18-month Saving 100,000 Lives campaign because it is the right thing to do," said Michael Youssi, MD, OSF Clinical Effectiveness Officer. "It is the right thing to do for our patients, our staff members and the communities we serve. We are dedicated to providing consistent, high quality care. We have programs in place that address the six recommendations made by the IHI campaign (listed below). However, we are continually seeking ways to raise the bar and improve care."

OSF was one of the five healthcare systems in the United States that worked with the IHI to shape the Campaign’s six recommendations for improving patient care. OSF St. Joseph Medical Center participates in the Institute for Healthcare Improvement’s 100,000 Lives Campaign. The 100,000 Lives Campaign engages U.S. hospitals in a commitment to implement changes in care proven to improve patient care and safety. OSF St. Joseph Medical Center participates in all six initiatives of the campaign. Those six recommendations are:

Deploy Rapid Response Teams—by allowing any staff member, regardless of position in the chain of command, to call upon a specialty team to examine a patient at the first sign of decline instead of waiting for a code situation.

OSF St. Joseph Medical Center has deployed a rapid response team. We are using an early-warning screening tool that assigns a severity score to the patient based on lab tests, vital signs, etc. If that score is a six or more on a 10-point scale, the Rapid Response Team is automatically called. The intent of the Rapid Response Team is for early recognition of a changing condition to implement treatment sooner.

And, we have not only deployed our Rapid Response Team, but we have also initiated Call FIRST, (Family Initiated Rapid Screening Team). Call FIRST allows family members to call for immediate support from the Rapid Response Team if they have seen a significant decline in the health of their loved one or if something seems not right. The goal of this initiative is to promote family involvement in patient care.

Deliver Reliable Evidence-Based Care for Acute Myocardial Infarction (heart attack)—by consistently delivering key measures - including early administration of aspirin and beta-blockers – that prevent patient deaths from heart attack.

In the last eight moths, we have been at 100% on six different AMI indicators (aspirin and beta blockers on arrival and discharge, evaluation of ventricular function, smoking cessation counseling, etc.) with just one exception.

Prevent Adverse Drug Events—by implementing medication reconciliation, which requires that a list of all of a patient’s medications (even for unrelated illnesses) be compiled and reconciled to ensure that the patient is given (or prescribed) the right medications at the correct dosages—at admission, discharge and before transferring to another care unit.

OSF St. Joseph Medical Center is recognized nationally as a success story in this area. Currently, we are averaging 90-100% of medication admission and discharge reconciliation. In FY 2005, our ADE (Adverse Drug Event—more commonly known as medication errors) rate per 1000 patient days went from 21.97 to 17.64. The rate so far in FY 2006 is 8.40.

Prevent Central Line Infections—by consistently delivering five interdependent, scientifically grounded steps collectively called the “Central Line Bundle.”

This is such an important initiative that our Medical Executive Committee has made the Central Line Bundle a Red Rule, which means that this is a mandatory practice from which there can be no deviation. The Central Line Bundle includes attire (cap, mask, gloves and gown), site preparation, and special supplies to proactively prevent the opportunity for infection. Staff has been empowered to stop any of these procedures immediately if all of the requirements of the Central Line Bundle are not met.

Prevent Surgical Site Infections—by reliably delivering the correct antibiotics before, during and after surgery, as well as maintaining glucose levels and avoiding shaving hair at the surgical site.

OSF St. Joseph Medical Center is nationally recognized as a mentor hospital to other healthcare facilities across the country in the fight to prevent surgical site infections. We are consistently at 91-100% in compliance with recommended practices for the last year. Kathy Haig, RN, Director of Quality for OSF St. Joseph Medical Center serves as an IHI 100,000 Lives Campaign mentor to other hospitals for surgical safety.

Prevent Ventilator-Associated Pneumonia—by implementing five interdependent, scientifically grounded steps collectively called the “Ventilator Bundle” – such as elevating the head of the hospital bed by 30 degrees – thereby dramatically reducing mortality and length of stay in the Intensive Care Unit.

We are at 93% compliance on ventilator-associated bundles, which include the following five required daily components:

• The head of the bed must be raised 30 degrees
• Patient must be awakened
• DVT prophylaxis to prevent blood clots
• Oral care
• Peptic ulcer disease prophylaxis

This has resulted in zero cases of ventilator associated pneumonia at OSF St. Joseph Medical Center in the past eight months.

"We are organizing a world-class campaign to elect quality,” said Dr. Donald Berwick, President and CEO of the Institute for Healthcare Improvement (IHI). “The health care organizations that join this campaign are not only demonstrating their commitment to improvement but their determination to put proven, life-saving improvement techniques into action.”

To learn more about the 100,000 Lives Campaign, go to www.ihi.org/ihi/programs/campaign.

The Institute for Healthcare Improvement (IHI) is a not-for-profit organization leading the improvement of health care throughout the world. Founded in 1991 and based in Cambridge, MA, IHI is a catalyst for change, cultivating innovative concepts for improving patient care and implementing programs for putting those ideas into action. Thousands of health care providers, including many of the finest hospitals in the world, participate in IHI’s groundbreaking work.