Care For PA

Since they became "mentor hospitals�? in the national "100,000 Lives�? and "5 Million Lives�? campaigns, seven Pennsylvania hospitals and health systems have had a huge impact on health care across Pennsylvania and the nation. These organizations have developed life-saving innovations and have agreed to share them with others in the United States, as well as provide support, advice, and tips.

Despite the extraordinary hard work and best intentions of caregivers, patients can experience an infection, drug interaction, surgical error, or other complication. The 100,000 Lives and 5 Million Lives campaigns are an effort of the Institute for Healthcare Improvement (a national nonprofit organization whose aim is better patient care) with the goals of preventing patient deaths and protecting patients from harm by encouraging hospitals to voluntarily adopt changes that are proven to save lives and reduce patient injuries. More than 3,000 hospitals eagerly signed up, including 144 from Pennsylvania.

The campaign goals closely align with other national quality and patient safety efforts involving hospitals, including those by the Institute of Medicine, Agency for Healthcare Quality and Research, Centers for Medicare & Medicaid Services, and The Joint Commission.

"There's clearly a national movement within the health care industry to improve quality and safety for all patients,�? said Carolyn F. Scanlan, president and CEO of The Hospital & Healthsystem Association of Pennsylvania (a nonprofit organization that helps to support the work of the hospitals across the state). "These eight hospitals, in addition to hospitals across the state, are making bold changes with remarkable outcomes,�? said Scanlan. "They serve as leaders and an inspiration to other hospitals across the nation.�?

Inspiring Success

Allegheny General Hospital's major accomplishment in the campaign was to reduce the number of central line-associated blood stream infections in patients by 90 percent by adopting certain standard procedures that are taken each time a patient requires the use of equipment like a catheter to be inserted into a large blood vessel. One example of a procedure that made a difference was scrubbing the skin with an antibacterial soap to reduce the number of bacteria on the patients' skin.

DuBois Regional Medical Center increased the number of patients who receive life-saving angioplasty within the recommended 90 minutes after arrival. The hospital improved its average to 89 percent of patients (well above the statewide average of 58 percent). In addition, the hospital also made changes in its processes that have reduced the number of central line-associated blood stream infections to zero. "Time is muscle in our patients with a heart attack. The faster we get our patients to the cardiac catheter lab, the more heart muscle is saved,�? says Daniel J. Ahearn M.D., MBA, FACP, vice president/medical affairs at the medical center.

Holy Spirit Hospital implemented a program to ensure that complete and accurate lists of patients' medications are documented, continually updated, and shared with all health care providers during patients' hospital stays. "Medication reconciliation benefits both patients and health care providers,�? said Fran Charney, Holy Spirit's director of risk management/patient safety officer. "The program focuses on the safety of our patients through the collaboration of our nursing and pharmacy staff. Patient safety is not the result of one individual or department; it is collaboration of many with one common vision: to save lives,�? Charney says. Being a mentor has allowed Holy Spirit to share its vision with other hospitals.

The Chester County Hospital implemented a plan for a "rapid response team�? to respond quickly to staff concerns about a patient's condition. The team, led most of the time by certified registered nurse practitioners, can be paged to the bedside of a patient who shows changes in heart rate, blood pressure, respiratory rate, acute chest pain, and other symptoms that indicate a possible emergency situation. Studies show that the early response to such warning signs has led to a 26 percent decrease in preventable deaths. The Chester County Hospital's efforts decreased deaths by between 70 and 85 percent in a six-month period.

The Veterans Affairs Pittsburgh Healthcare System worked with 33 other hospitals in the region to establish protocols and data collection standards that have dramatically reduced the number of patients with a certain type of infection, Methicillin-resistant Staphylococcus aureus, or "MRSA.�? The universal screening, rigorous hand-washing rules, and the sterilization of all equipment used on patients with MRSA have lowered the infection rate by more than 70 percent in the surgical unit at the system. The results have been so successful that it has become a national model, including all 150 VA hospitals.

Looking Ahead

Pennsylvania hospitals are already seeing improvements in health care measurers as a result of the IHI and other quality improvement efforts, and it's making a difference in the lives of patients.

"It's certain that health care will never be the same, but the improvements achieved so far--combined with the commitment and diligence of Pennsylvania's hospital trustees, administrators, physicians, nurses, and other health care professionals--show that the future of Pennsylvania's health care looks very bright,�? says Scanlan.

"We encourage others--such as nursing homes, insurers, and government agencies--to work together in a collaborative approach to achieve a common goal of making health care in Pennsylvania as safe and as cost effective as possible.�?

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