July / August 2006
NEWS ITEMS FROM SOURCES WORLDWIDE
Pulse
100,000 Lives Campaign Exceeds Goal
The Institute for Healthcare Improvement (IHI) announced in June that U.S. hospitals taking part in an unprecedented 18-month effort to prevent 100,000 unnecessary deaths by dramatically improving patient care have exceeded that goal. Hospitals enrolled in the 100,000 Lives Campaign have collectively prevented an estimated 122,300 avoidable deaths and, as importantly, have begun to institutionalize new standards of care that will continue to save lives and improve health outcomes into the future.
Initiated by IHI in December 2004, the Campaign has enrolled more than 3,000 hospitals — representing an estimated 75% of U.S. hospital bed — and far surpassed the enrollment original goal of 2,000. The participating hospitals have pledged to implement up to six evidence-based and life-saving interventions. Dr. Donald Berwick, president and CEO of IHI, announced the results at IHI's 2nd Annual International Summit on Redesigning Hospital Care.
As a result of the Campaign, many patients have begun to enjoy a new standard of care. Over 20 facilities have reported that they have gone over a year without a ventilator-associated pneumonia, a leading killer among all hospital-acquired infections, demonstrating that this sort of complication can be avoided and is not inevitable. Hundreds of hospitals have also now instituted rapid response teams, a relatively new concept that is saving lives. Participating hospitals have also made great headway in delivering reliable care for acute myocardial infarction, preventing adverse drug events, and preventing surgical site and central line infections.
"The Campaign has built a powerful network of generous national partners, active regional field offices (nodes) and deeply committed hospitals, all devoted to aligning aims, offering support and learning from one another on an ongoing basis," said Joseph McCannon, campaign manager for IHI.
Source: Institute for Healthcare Improvement
Action Needed to Bolster Nation's Emergency Care System
Despite the lifesaving feats performed every day by emergency departments and ambulance services, the nation's emergency medical system as a whole is overburdened, underfunded, and highly fragmented, saysİa series of three reports from the Institute of Medicine.
As a result, ambulances are turned away from emergency departments once every minute on average and patients in many areas may wait hours or even days for a hospital bed.İ Moreover, the system is ill-prepared to handle surges from disasters such as hurricanes, terrorist attacks, or disease outbreaks.
The Institute of Medicine's Committee on the Future of Emergency Care in the United States Health System was convened in 2003 to examine the state of emergency care in the U.S., to create a vision for the future of emergency care, including trauma care, and to make recommendations to help the nation achieve that vision.İ Their findings and recommendations are presented in three reports:
Hospital-Based Emergency Care: At the Breaking Point explores the changing role of the hospital emergency department and describes the national epidemic of overcrowded emergency departments and trauma centers.
Emergency Medical Services At the Crossroads describes the development of EMS systems over the last forty years and the fragmented system that exists today.
Emergency Care for Children: Growing Pains describes the unique challenges of emergency care for children.
The reports were released on June 14, 2006, and are available from the National Academies Press at www.nap.edu/category.html?id=ms.
Source: Institute of Medicine
NQF Endorses Framework for Evaluating Palliative and Hospice Care Quality
The quality of care for patients at the end of life — including the provision of healthcare, alleviation of pain, and understanding and respecting the wishes of patients and their families — is of high concern among healthcare consumers, providers, and other stakeholders. The National Quality Forum (NQF) has addressed this issue by announcing endorsement of a National Framework and Preferred Practices for Palliative and Hospice Care Quality. The NQF Board of Directors endorsed a comprehensive framework for evaluating the quality of palliative and hospice care; a set of 38 preferred practices for delivering high-quality palliative and hospice care; and 9 recommendations for research to improve upon the measurement and evaluation of palliative and hospice care.
The framework is based, in part, on Clinical Practice Guidelines for Quality Palliative Care, issued in May 2004 by the National Consensus Project — a consortium of the American Academy of Hospice and Palliative Care, Center to Advance Palliative Care, Hospice and Palliative Nurses Association, Last Acts Partnership, and National Hospice and Palliative Care Organization — whose mission was to reach consensus on clinical practice guidelines for palliative care. NQF also conducted a literature search to identify other national frameworks for palliative and hospice care.
The framework items include definitions for palliative and hospice care; purpose of the framework; goals, principles, scope, structural/programmatic elements, and domains of palliative/hospice care; and levels of measurement, outcomes, preferred practices, and performance measures. The research recommendations identify pressing needs in the areas of structure and processes of care; physical, psychological/psychiatric, social, spiritual, religious, and existential, and cultural aspects of care; care of the imminently dying patient; ethical and legal aspects of care; and topics that cross domains.
Source: National Quality Forum
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