Campaign promotes safety in hospitals

Wash your hands. Make sure the head of the patient's bed is at a 30-degree angle. Hand out aspirins.

None of this is, as they say, brain surgery. But low-tech, common-sense details like these can help save thousands of lives, according to a nationwide bus tour that rolled into Utah last week.

The "100,000 lives campaign," the brainchild of the Institute for Healthcare Improvement, aims to prevent that many hospital deaths by June 2006. Traveling from Boston to Seattle, with 14 stops in between, staff members from the Massachusetts-based nonprofit are touring hospitals to spread the word.

In Salt Lake City, the bus stopped at University of Utah Hospital and at the Veterans Administration Hospital, two of the 2,800 acute-care hospitals in the United States (and 28 in Utah) that have signed on to IHI's campaign. The campaign is part of the IHI's challenge to U.S. hospitals to adopt evidence-based practices and safeguards, some of which cost nothing to implement.

For example, it's now known that when a patient is on a ventilator, the head of his bed should be elevated to between 30 and 40 degrees to prevent him from aspirating bacteria and developing pneumonia. Also, giving patients aspirin to prevent blood clots and Beta blockers to prevent further heart attacks, can also save lives.

"It's the courage to think small," University of Utah Hospital RN Jane Stetich told ISI members and visitors from Health Insight, a local nonprofit whose goal is health-care-quality improvement in Utah and Nevada.

Stetich brought this new perspective back to the U. Hospital after attending an ISI meeting last fall. That's where she learned the 30-degree rule, and the importance of rinsing out the mouths of ventilator patients every four hours to reduce the amount of bacteria.

When a nurse is treating life-threatening infections and keeping track of dozens of monitors, something as simple as cleaning the patient's mouth can get overlooked, she said. So it's the goal of the 100,000 lives campaign to create a hospital-wide system that makes sure these kinds of practices actually get done.

"These are all the things every patient has a right to, every time," says Marc Bennett, president and CEO of Health Insight. But, overall, hospitals provide recommended care 80 percent of the time, he says.

"Every doctor and nurse gets up in the morning wanting to provide the best care possible," Bennett says. "But the complexity of the day and the complexity of care means that things slip through the cracks."