A widely heralded Johns Hopkins safety initiative to
reduce bloodstream infections in intensive
care units was implemented in 30 states starting Feb. 1 and
could save an estimated $3 billion and
30,000 lives annually. In addition, the program has been
launched in Spain and will begin in the United
Kingdom starting in April. Pilot programs are also under
discussion with health care leaders in Peru and
Chile.
"We ran this program in 77 hospitals and 103 intensive
care units in Michigan for 18 months, and
infection rates dropped 66 percent," said Peter Pronovost,
director of the Johns Hopkins
Quality and Safety Research Group, or QSRG. "As a
result, $200 million and an estimated 2,000 lives were
saved.
I'm confident we'll see a similar result nationwide."
The national program, National Implementation of the
Comprehensive Unit-Based Safety
Program to Reduce Central Line-Associated Blood Stream
Infections in the ICU — "On the CUSP, Stop
BSIs," for short — will continue through Sept. 29,
2011. It's based on a checklist Pronovost created
that significantly lowered CLABSI infections at Johns
Hopkins and later throughout members of the
Michigan Health & Hospital Association.
The international push is a cooperative effort between
QSRG and the World Health
Organization, except in the United Kingdom, where QSRG is
working directly with representatives of
that country.
The checklist contains five important steps that need
to be followed when placing a central line
catheter. This type of catheter is used regularly for
patients in the ICU to administer medication or
fluids, obtain blood tests and directly gauge
cardiovascular measurements such as central venous
blood pressure. Each year, roughly 80,000 patients become
infected, and 30,000 to 60,000 die at a
cost of $3 billion nationally.
Pronovost says his next step will be to apply his
checklists to other health care problems that
are costing money and lives, such as methicillin-resistant
staphylococcus aureus, known as MRSA, and
vancomycin-resistant enterococcus, or VRE. Illnesses caused
by these bacteria are among the most
common health care-acquired infections in the United
States, affecting one in 10 patients, killing
approximately 90,000 individuals and costing between $5
billion and $11 billion annually, Pronovost
said.
CUSP is a collaborative effort between Johns Hopkins'
Quality and Safety Research Group, the
Health Research & Educational Trust and the Michigan Health
& Hospital Association Keystone Center
for Patient Safety and Quality. Funding comes from the
Agency for Healthcare Research and Quality,
the Sandler Foundation of the Jewish Community Endowment
Fund and an anonymous donor.
Pronovost, recipient of a MacArthur "genius" grant,
was named one of the world's most
influential people of 2008 by Time magazine for his work in
patient safety. The magazine's annual list
recognizes people "whose power, talent or moral example is
transforming our world."