Hospitals Slow to Adopt Renowned Program
A Johns Hopkins University professor is on a crusade to end blood stream infections. Will Oregon hospitals participate?
Hospitals in Michigan have proven that blood stream infections in Intensive Care Units could be reduced to zero thanks to a program led by Dr. Peter Pronovost, a professor at Johns Hopkins University’s Quality and Safety Research Group
Pronovost, who created the Stop BSI campaign, spoke at the annual conference of the Association of Health Care Journalists in Chicago on April 24.
“What other industry would be tolerated that kills 31,000 people nationally every year?” Pronovost said. “Our ego and arrogance (as physicians) keeps us from participating and has to end. We need to work to rally and make this the polio campaign."
In Michigan, hospitals have used the Stop BSI program guidelines of checklists, verified reporting and patient safety measures to sustain their results over the past four years.
Hospitals in 28 states, including Oregon, have started adopting the guidelines. But so far just two Oregon hospitals have signed up over the past year – Sky Lakes Medical Center in Klamath Falls and Coos Bay Hospital – far less than in other states that began the program around the same time.
“Just because there are two hospitals at this point, doesn’t mean other hospitals don’t have efforts in place,” said Diane Waldo with the Oregon Association of Hospitals and Health Systems which leads the effort to market the program to hospitals statewide.
Waldo said the guidelines require some significant procedural and cultural changes between doctors and nurses that will take some time. “It takes some dedicated effort,” she said. “It’s not something that can be changed overnight.”
Oregon hospitals are making progress. Close to 80 percent are in some stage of adopting a standardized World Health Organization surgical checklist, and about a dozen hospitals plan to take part in a pilot program by the Patient Safety Commission to reduce infections including BSI, said Jim Dameron, commission administrator.
Last year, Health and Human Services Secretary Kathleen Sebelius called on all U.S. hospitals to reduce blood stream infections from ICUs by 75 percent over three years. The effort would save close to $3 billion and up to 60,000 lives per year.
Pronovost said he chose to take on central line associated blood stream infections because they are extremely resilient and preventable.
"No one is accountable for these deaths," Pronovost told the crowd of healthcare journalists gathered in Chicago. "We know people are dying needlessly. We need to accept responsibility and not pass the buck. No one has publicly apologized for these deaths and we need to see some apologies.”
He called for accountability and transparency, such as public infection rate reporting like that in Oregon set to come out for the first time next month. The report due out by the Oregon Office of Health Policy includes central line blood stream infections and surgical site infections.
Pronovost called for CMS to post all hospital-specific infection rates on the Internet. "We need to destroy the myth that we're perfect," he said.
Reporting from Chicago by Diane Lund-Muzikant
For more information about the Stop BSI campaign go to www.safercare.net.
For related articles in infections and other medical mistakes click here.
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You note above that two Oregon hospitals have adopted the Stop BSI guidelines. Please note the May 8 article in the Oregonian talking about Adventist Medical Center's extremely low infection rates - ZERO since Spring 2007 - as a result of the work they've done with this program. AMC is one of three hospitals in the state following these guidelines. http://www.oregonlive.com/health/index.ssf/2010/05/preventing_hospital_i...
It may be that many other hospitals are using it or the nearly identical IHI bundle for blood stream catheters.
Good for The Lund Report for shining a light on such quality of care issues. We over-invest in costly but remunerative services, and under-invest in the nitty gritty issues like this one. That has been true since quality became a topic decades ago. Scrutiny, pressure and "heat" are necessary to spur investment in the many known and proven strategies that keep all of us from suffering unnecessary harm as patients.
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