A Johns Hopkins-led safety checklist program that virtually eliminated bloodstream infections in hospital intensive-care units throughout Michigan appears to have also reduced deaths by 10%, a new study suggests. Although prior research showed a major reduction in central-line related bloodstream infections at hospitals using the checklist, the new study is the first to show its use directly lowered mortality.
“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 and leader of the study published in BMJ, stated in a press release. “Thousands of people are believed to have survived because of this effort to reduce bloodstream infections.”
Pronovost’s previous research has shown that coupling a cockpit-style, infection-control checklist he developed with a work environment that encourages nurses to speak up if safety rules are not followed reduced ICU central-line bloodstream infections to nearly zero at The Johns Hopkins Hospital and at hospitals throughout the states of Michigan and Rhode Island. Experts say an estimated 80,000 patients a year with central lines get infected, some 31,000 die and the cost of treating them may be as high as $3 billion nationally.
For the new study, Pronovost and his team, using Medicare claims data, studied hospital mortality of patients admitted to ICUs in Michigan before, during and after what is known as the Keystone ICU Project, which features the checklist. They compared the Michigan information to similar data from 11 surrounding states. While data from both Michigan and the other states showed a reduction in hospital deaths of elderly patients admitted to ICUs throughout the 5-year period from October 2001 to December 2006, the patients in Michigan were significantly more likely to survive a hospital stay during and after the Keystone project.
These findings can not definitively attribute the mortality reduction to the Keystone project, Pronovost stated, but no other known large-scale initiatives were uniquely introduced across Michigan during the study period.
“This is perhaps the only large-scale study to suggest a significant reduction in mortality from a quality-improvement initiative,” Pronovost stated.