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Safety checklist use yields 10 percent drop in hospital deaths
Date:2/1/2011

itted to ICUs over the five-year period from October 2001 to December 2006, the patients in Michigan were significantly more likely to survive a hospital stay during and after the Keystone project.

These findings cannot definitively attribute the mortality reduction to the Keystone project, Pronovost says, but no other known large-scale initiatives were uniquely introduced across Michigan during the study period. "This is perhaps the only large-scale study to suggest a significant reduction in mortality from a quality-improvement initiative," Pronovost says.

The Keystone ICU Project, developed at Johns Hopkins, includes a much-heralded checklist for doctors and nurses to follow when placing a central-line catheter, highlighting five cautionary and basic steps from hand-washing to avoiding placement in the groin area where infection rates are higher. Along with the checklist, the program promotes a "culture of safety" that comprises safety science education, training in ways to identify potential safety problems, development of evidence-based solutions, and measurement of improvements. The program also empowers all caregivers, no matter how senior or junior, to question each other and stop procedures if safety is compromised.

Central lines are thin plastic tubes used regularly for patients in ICUs to administer medication or fluids, obtain blood for tests, and directly gauge cardiovascular measurements such as central venous blood pressure. But the tubes are easily contaminated.

In 2009, U.S. Health and Human Services Secretary Kathleen Sebelius called for a 50 percent reduction in catheter-related infections nationwide by 2012. To that end, in partnership with a branch of the American Hospital Association and the Michigan Hospital Association, the Johns Hopkins model is being rolled out state-by-state across the country. Forty states have launched the program, and preliminary data from some of the early adopters is very encoura
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Contact: Stephanie Desmon
sdesmon1@jhmi.edu
410-955-8665
Johns Hopkins Medical Institutions
Source:Eurekalert

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