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Initiative to reduce health care-associated infections resulted in decreased mortality
Lipitz-Snyderman A. BMJ. 2011;doi:10.1136/bmj.d219.
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Older Americans being treated in Michigan intensive care units were less likely to die than patients treated in other Midwestern hospitals, according to a study evaluating an initiative known as the Keystone Project, which sought to reduce the number of infections associated with health care.
According to the CDC, health care-associated infections are one of the most common complications of hospital care, accounting for an estimated 1.7 million infections and 99,000 associated deaths in 2002. These infections are responsible for $28 billion to $34 billion in preventable health care expenses every year.
Researchers from Johns Hopkins University developed the initiative — the Michigan Health and Hospital Association Keystone ICU project — to improve patient safety. The project included promoting a culture of safety, improving communication between providers and implementing evidence-based practices to reduce rates of catheter-related bloodstream infections and ventilator-associated pneumonia.
For the study, the researchers evaluated whether the implementation of this initiative was associated with reduced hospital mortality and length of stay for Americans aged 65 years or older. The retrospective comparative study was conducted using data from Medicare claims.
The study period spanned from October 2001 to December 2006. It included 2 years before the Keystone Project was initiated and 22 months after its implementation. The sample included hospital admissions in 95 hospitals in Michigan, where the project was implemented, and admissions from 364 hospitals in the surrounding Midwest region.
They found that a person’s chance of dying decreased by 24% in the hospitals in Michigan after the program was implemented compared with a 16% reduction in the surrounding states where the program was not implemented. They did not find a difference between the two groups in the length of stay in the hospital.
“We knew that when we applied safety science principles to the delivery of health care, we would dramatically reduce infections in intensive care units, and now we know we are also saving lives,” Peter J. Pronovost, MD, PhD, a professor of anesthesiology and critical care medicine at The Johns Hopkins University School of Medicine, said in a press release.
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