An Example of Action: The 100K Lives Campaign

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The Campaign ended in June 2006 with an estimated 122,300 lives saved! Please stay tuned for the announcement of the next phase of the Campaign at our 18th National Forum in December.

“The names of the patients whose lives we save can never be known. Our contribution will be what did not happen to them. And, though they are unknown, we will know that mothers and fathers are at graduations and weddings they would have missed, and that grandchildren will know grandparents they might never have known, and holidays will be taken, and work completed, and books read, and symphonies heard, and gardens tended that, without our work, would never have been.”


Donald M. Berwick, MD, MPP
President and CEO
Institute for Healthcare Improvement



We invite you to join a Campaign to make health care safer and more effective — to ensure that hospitals achieve the best possible outcomes for all patients.



A Flawed System
Health care is a highly complex system with many broken parts. The good news is that for every broken part in our system, there are remarkable examples of excellence — organizations that have overcome enormous obstacles to redesign the way patient care is delivered.



Unfortunately, these examples are too few. As the Institute of Medicine (IOM) declared in 2001, in words that still ring true, “Between the health care we have and the care we could have lies not just a gap, but a chasm.” Health care does not yet reliably transfer best-known science into action, and processes frequently fail, despite the best intentions of a dedicated and highly skilled workforce. Our system, which intends to heal, too often does just the opposite — leading to unintended harm and unnecessary deaths at alarming rates.



100,000 Lives
IHI and other organizations that share our mission are convinced that a remarkably few proven interventions, implemented on a wide enough scale, can avoid 100,000 deaths over the next 18 months, and every year thereafter.



Hundreds of health care organizations have been making changes that improve care and reduce patient harm. Now is the time to harness those experiences and apply the best methods reliably 100% of the time. This is essential in the face of these disturbing statistics:

The IOM estimates that as many as 98,000 people die each year in US hospitals due to medical injuries.
The Centers for Disease Control and Prevention estimate that two million patients suffer hospital-acquired infections each year.
The US spends the most money on health care of all (advanced) industrialized nations [1], but it performs more poorly than most on many measures of health care quality [2].


These circumstances are not acceptable. It is time to change; and you can help.



The Campaign
IHI will join hands with other leading American health care organizations in launching an unprecedented 100,000 Lives Campaign, which will disseminate powerful improvement tools, with supporting expertise, throughout the American health care system.



This campaign aims to enlist thousands of hospitals across the country in a commitment to implement changes in care that have been proven to prevent avoidable deaths. We are starting with these six changes:



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 called the “Central Line Bundle”
Prevent Surgical Site Infections…by reliably delivering the correct perioperative care
Prevent Ventilator-Associated Pneumonia…by implementing a series of interdependent, scientifically grounded steps called the “Ventilator Bundle”


Detailed information on each of these six changes is available in the "Materials" section and will be augmented over the course of the Campaign. In addition to these six changes, IHI will continuously seek and add others that have been shown to save lives.



Whether a hospital chooses to apply all, or some, of the recommended interventions, their results will be routinely tracked and measured, and will serve as a regular barometer for the Campaign’s progress.



Get Involved
There’s no cost to joining the 100,000 Lives Campaign, but your organization must be ready to make some changes and willing to report back on your progress.



The first step is to sign up — simply go to the "Sign Up" tab. In the Campaign area on IHI's website, you’ll find everything you need to know to implement the recommended changes at your institution, including detailed information about each intervention, useful tools, and helpful resources. The site will also feature information on other ways that individuals and organizations can help with the Campaign.



Some Is Not a Number. Soon Is Not a Time.



The number is 100,000. The time is NOW. The goal is achievable, but we need your help. Please be part of the 100,000 Lives Campaign.



_______________________________

[1] Reinhardt UE, Hussey PS, Anderson GF. US health care spending in an international context. Health Affairs. 2004;23(3):10-25.

[2] Blendon RJ, Schoen C, DesRoches CM, Osborn R, Zapert K, Raleigh E. Confronting competing demands to improve quality: A five-country hospital survey. Health Affairs. 2004;23(3):119-135.

I was lucky enough to be in the audience when Don Berwick announced the 100K Lives Campaign and called health care workers to action. It's tough to imagine a more inspirational moment.

Since this forum is dirven by and meant for students, it's interesting to note that the majority of hospitals who joined the 100K Campaign were community hospitals, not academic medical centers (i.e. those with medical schools). There were some, of course, but it is striking how many of the most highly regarded academic medical centers (the big names and those ranked most highly by US News and World Report, whatever that means) did not publicly join the Campaign.

Are community hospitals that follow more of a business or customer service model simply more nimble and able to change strategic direction more easily, more responsive for some reason to the type of guidance and leadership an organization like IHI can provide, perhaps more humble than academic medical centers, or simply more aware of the quality improvement movement?

I really don't know, but I'd be very interested in others' opinions.

Originally Posted by Gumption

...it is striking how many of the most highly regarded academic medical centers (the big names and those ranked most highly by US News and World Report, whatever that means) did not publicly join the Campaign.

As far I know, all the major academic centers across the country joined the Campaign, and many participated very enthusiastically. The list of all the hospitals that signed on is available here.

Originally Posted by Gumption

Are community hospitals that follow more of a business or customer service model simply more nimble and able to change strategic direction more easily, more responsive for some reason to the type of guidance and leadership an organization like IHI can provide, perhaps more humble than academic medical centers, or simply more aware of the quality improvement movement?

That's a very interesting question. My guess is that there are a number of factors at play here. I definitely agree that, due to their smaller size, community hospitals can be very nimble and aggressive in implementing something like the 100k Lives Campaign. When comparing community and academic hospitals, we probably also need to consider that the teaching mission of the hospital plays a big role in this question. The fact that an academic center has full time house staff with lots of residents completely changes the dynamic. One also has to wonder how the teaching and quality missions may in some cases diverge.

Anyway, just food for thought. I, too, am curious about others' opinions. I'm especially interested to know what others thing about the humility question you raise, Gumption. On the one hand, there is a certain extent to which we have to believe that academic centers are indeed a world apart, are at the cutting edge, and are therefore lacking desire (perhaps rightly, perhaps wrongly) to work with others in dissimilar positions. On the other, I'd like to think -- and have in fact observed -- that academic centers are just as interested as community centers in working with fellow hospitals to improve. I have seen some really great work in quality at academic centers, and they have been eager to share as well as learn from others.

Great topic for debate!

A

I appreciate your thoughtful comments, AGN.

There are many academic medical centers who have signed on to the Campaign, but not ALL. I've been following the signees since the start of the Campaign, and there are still a few (not to name names) midwestern major AMCs who have not signed on publicly. One interesting pattern is that private institutions seemed to be more willing to sign on earlier in the Campaign, which raises some interesting questions about the business case for quality ...

Pleased to read your article on"The 100K Lives Campaign".Nice thoughts, thanks for sharing it.

When is the next phase of the campaign???