On June 14, 2006, Hospital for Special Surgery (HSS), a proud participant in the Institute for Healthcare Improvement’s 100,000 Lives Campaign, joined more than 3000 participating hospitals nationally to celebrate achievements in adopting best practices to keep patients safe. By December of that same year, the campaign had proven so successful that it has changed its name to the 5 Million Lives Campaign, with a goal of protecting patients from five million incidents of medical harm by December 2008.
Founded in 1991, the Institute for Healthcare Improvement (IHI) is a not-for-profit organization leading the improvement of health care throughout the world. The IHI has partnered with prominent agencies nationwide, including The Joint Commission, the American Medical Association, the American Nurses Association, and the National Association of Health Care Quality, to spread the implementation of best practices in the delivery of patient care.
The initiatives in patient care championed by the IHI are consistent with our HSS mission to provide the highest quality patient care. At HSS, teams of skilled clinicians and dedicated administrators have been working to evaluate the applicability of the IHI initiatives to the specialty services we provide.
The IHI initiative to Prevent Surgical Site Infections by consistently giving the correct antibiotic, at the proper time, to prevent postoperative infection requires a coordinated effort by the healthcare team. Evidence shows there is only a small window of opportunity before and after surgery in which the antibiotic can be given to prevent surgical wound infections from developing. HSS was already a leader in preventing surgical site infections when the Campaign kicked off in June 2005. HSS support staff, surgeons, anesthesiologists, and nurses work together to coordinate the care necessary to achieve this goal. Due to our efforts, Hospital for Special Surgery is ranked in the top 10% of hospitals nationally that reliably give the antibiotic before surgery. Additionally, we meet the goal of stopping the prophylactic antibiotic within 24 hours after surgery 93% of the time (1). The HSS team is working diligently to improve even these high scores.
The Institute of Medicine’s landmark 1999 report, To Err is Human, along with many other recent studies, underscored the need for safer medication practices. HSS teams had already been hard at work to prevent medication-related errors when the IHI Campaign began. Interdisciplinary teams of nurses, pharmacists, physicians and physician assistants, such as the HSS Coumadin Safety team and the Partnering with Patients to Improve Medication Safety team, harmonized their efforts under the IHI umbrella of practices recommended to Prevent Adverse Drug Events. Together, these teams have developed new processes aimed at obtaining a comprehensive list of medications taken prior to coming into the hospital and ensuring that changes made to medications during hospitalization are accurately communicated at the time of discharge. At HSS, we know that patient understanding of why medications are prescribed - and the right ways of taking them - is essential to the process of recovery.
While some of the initiatives of the IHI campaign do not apply to the specialty orthopedic and rheumatologic care that attracts international patients to HSS, we are committed to evaluating all of the IHI initiatives for opportunities to further excel in the care we provide. Under the IHI initiative Deploying Rapid Response Teams, hospitals are finding new ways to recognize, as early as possible, when patients need a fast, coordinated response to an unexpected change in health status. The HSS team evaluating this IHI initiative has adapted the suggested criteria for determining when patients require a rapid response to their unique needs in our specialty hospital.
The IHI, its partners, and its participant hospitals - like Hospital for Special Surgery - will work to hold gains made in patient safety and anticipate exploring new opportunities for improvement.
1. "Hospital Compare." United States Department of Health & Human Services. United States Department of Health & Human Services. 7 May 2006 <http://www.hospitalcompare.hhs.gov/>
Kohn LT, Corrigan JM, Donaldson MS, editors, Committee on Quality of Health Care in America, Institute of Medicine, To Err Is Human: Building a Safer Health Care System, National Academy Press, Washington, DC, 1999.
“Institute for Healthcare Improvement: About Us.” Institute for Healthcare Improvement. Institute for Healthcare Improvement. 7 May 2006
“Institute for Healthcare Improvement: Programs: 100K Lives Campaign.” Institute for Healthcare Improvement. Institute for Healthcare Improvement. 7 May 2006
“Institute for Healthcare Improvement.” Institute for Healthcare Improvement. Institute for Healthcare Improvement. 7 May 2006
Joint Commission on Accreditation of Healthcare Organizations©. Quality Report. New York Society for the Relief of the Ruptured & Crippled. Version 18; 2/28/06.