New Jersey Hospital Association Quality Initiative Saves Lives; Efforts by 18 Hospital ICUs Prevented 216 Deaths30 June 2006
The New Jersey Hospital Association today celebrated the completion of an intensive two-year initiative to improve the quality of care in hospital intensive care units with some dramatic results: a potential for 216 deaths averted, thanks to greatly reduced instances of pneumonia and bloodstream infections.
The results were announced today during a daylong learning session and celebration at the Hyatt Regency Princeton to wrap up the initiative. A total of 35 hospitals participated in "The NJHA Collaborative to Improve Quality of Care and Patient Safety in the ICU," part of the NJHA Quality Institute. Eighteen of those facilities were on board for the full two years of the initiative and were able to compile data that showed the tremendous potential for saving lives and reducing healthcare costs. (A full list of participating hospitals is attached.)
Collectively, those 18 hospitals reduced the incidence of bloodstream infections in intensive care patients by 73 percent. The occurrence of ventilator-associated pneumonia fell 55 percent. Both are potentially fatal complications that can arise in critically ill patients in intensive care units.
Using average mortality rates from medial literature and used by the Institute for Healthcare Improvement in its 100,00 Lives Campaign, the collaborative helped prevent a potential of 137 patient deaths due to bloodstream infections and 79 potential deaths due to pneumonia.
"Thanks to this effort, there are scores of New Jersey residents sharing their lives with their families and loved ones," said Aline Holmes, RN, NJHA's senior vice president of clinical affairs. "This is thrilling news to the New Jersey healthcare professionals who dedicated themselves to this effort. These hospitals and their staffs saved lives through hard work, a commitment to improve and a willingness to change. They are a model for future quality improvement efforts across our state."
Launched in 2004, the collaborative asked hospital teams to sign on for an intensive examination of the policies and practices in their intensive care units. Each participant agreed to share its successes and failures with other hospitals in the collaborative. The group discussed its efforts at periodic two- day learning sessions hosted by NJHA, along with regular conference calls and e-mails. The effort was co-chaired by two respected physicians dedicated to quality improvement: Peter Pronovost, MD, PhD, medical director of the Center for Innovations in Quality Patient Care at the Johns Hopkins University School of Medicine, and Tom Rainey, MD, president of CriticalMed Inc., a leading consulting group on critical care and quality matters.
"You will never really know the extent of the impact you have made, but you can be confident and proud that it has been monumental and will be enduring," Rainey stated to the collaborative's members.
Added Pronovost, "Improving healthcare quality and safety is neither easy nor quick, but it is work that is worth the effort."
As part of their journey, the hospitals implemented best practices for improving care that can be replicated in ICUs across the state and beyond. While the two-year collaborative is now officially ended, group members will continue to gather occasionally to help sustain their achievements and also to mentor other hospital teams.
In addition to improved patient care, the collaborative's results translate into dramatic cost savings. Once again using methodology developed by IHI, the cost avoidance associated with the averted instances of bloodstream infections and pneumonia reached more than $11 million. That's the cost that would have been associated with treating those conditions. The total breaks down to $5.7 million in cost avoidance for 166 bloodstream infection patients at $34,500 per episode and $5.8 million in cost avoidance for 146 pneumonia patients at $40,000 per episode.
"Quality improvement efforts are a sound investment, as these numbers dramatically illustrate," said NJHA President and CEO Gary Carter. "All of us - medical professionals, hospital executives, policy makers and government officials alike - must commit to a sound healthcare delivery system that can afford to invest in these tremendously worthwhile efforts."
The 35 participants set a number of goals, some collectively and some individually. Collectively, the participants aimed to reduce their bloodstream infections and ventilator-associated pneumonia cases to the 25th percentile of the CDC's National Nosocomial Infection Surveillance Project data. Both goals were met.
In addition, a number of individual facilities were recognized for their impressive statistics during the second year of the initiative. Similar honors were presented last June for hospital achievements in the project's first year. While other participating hospitals may also have posted significant results, today's honorees recognized specifically for year two data were:
19 months with no ventilator-associated pneumonia --
Newark Beth Israel Medical Center, Newark
13 months with no ventilator-associated pneumonia --
Monmouth Medical Center, Long Branch
One year with no ventilator-associated pneumonia -- Palisades Medical Center, North Bergen
Southern Ocean County Hospital, Manahawkin
Six months with no ventilator-associated pneumonia --
Burdette Tomlin Memorial Hospital, Cape May Court House
Community Medical Center, Toms River CentraState Medical Center, Freehold
University Medical Center at Princeton
Saint Barnabas Medical Center, Livingston
Riverview Medical Center, Red Bank
One year with no central-line bloodstream infections --
CentraState Medical Center, Freehold
Monmouth Medical Center, Long Branch
Palisades Medical Center, North Bergen
Six months with no central-line bloodstream infections -- AtlantiCare Health System, Atlantic City and Pomona
Burdette Tomlin Memorial Hospital, Cape May Court House
Kimball Medical Center, Lakewood
LibertyHealth Meadowlands Hospital, Secaucus
Newark Beth Israel Medical Center, Newark
Virtua Memorial Hospital, Berlin
Most significant improvement in safety culture in the ICU --
CentraState Medical Center, Freehold
See next page for full list of participants.
Members of the N.J. Collaborative to Improve Quality of Care and Patient Safety in the ICU include:
AtlantiCare Regional Medical Center, City and Mainland divisions, Atlantic City and Pomona
Burdette Tomlin Memorial Hospital, Cape May Court House
Capital Health System, Fuld and Mercer campuses, Trenton
CentraState Medical Center, Freehold Clara Maass Medical Center, Saint Barnabas Health Care System, Belleville
Community Medical Center, Saint Barnabas Health Care System, Toms River
Cooper University Hospital, Camden
East Orange General Hospital, East Orange
LibertyHealth Greenville Hospital, Jersey City
Irvington General Hospital, Irvington
LibertyHealth Jersey City Medical Center, Jersey City
Jersey Shore University Medical Center, Meridian Health, Neptune
Kimball Medical Center, Saint Barnabas Health Care System, Lakewood
LibertyHealth Meadowlands Hospitals, Secaucus
Monmouth Medical Center, Saint Barnabas Health Care System, Long Branch
Newark Beth Israel Medical Center, Saint Barnabas Health Care System, Newark Ocean Medical Center, Meridian Health, Brick
Palisades Medical Center, New York-Presbyterian Healthcare System, North Bergen
University Medical Center at Princeton
Raritan Bay Medical Center, Old Bridge and Perth Amboy
Riverview Medical Center, Meridian Health, Red Bank
Saint Barnabas Medical Center, Saint Barnabas Health Care System, Livingston
St. Francis Medical Center, Trenton
St. Joseph's Regional Medical Center, Paterson
Saint Michael's Medical Center, Cathedral Healthcare Systems, Newark
Somerset Medical Center, Somerville
Southern Ocean County Hospital, Manahawkin Union Hospital, Saint Barnabas Health Care System, Union The Valley Hospital, Ridgewood
Virtua Health- Burlington County, Berlin, Marlton and Voorhees
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