Saving 100 000 lives in US hospitals

doi:10.1136/bmj.332.7553.1328

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C Joseph McCannon (jmccannon@ihi.org), 100 000 Lives Campaign manager1,
Marie W Schall, director1,
David R Calkins, senior fellow1,
Alexander G Nazem, 100 000 Lives Campaign national field manager1

¹ Institute for Healthcare Improvement, 20 University Avenue, Cambridge, MA 02138, USA

Correspondence to: C J McCannon

An initiative to cut avoidable deaths required rapid recruitment and support of large numbers of US hospitals. Campaign leaders describe how they coordinate nationwide implementation of effective healthcare interventions and document lessons for effective spread

The quality of health care in the United States varies greatly.1^–3 A study in 2003 showed that Americans receive “recommended care” just over 50% of the time.4 In response to growing national consensus among key provider, payer, and employer stakeholders about the inadequate pace of change, the Institute for Healthcare Improvement launched the 100 000 Lives Campaign in December 2004. Since then the institute, a not-for-profit organisation whose mission is to accelerate the improvement of health care in the US and internationally, has engaged over 3000 US hospitals (representing over 80% of total US hospital discharges) in this national initiative. The campaign aims to avoid 100 000 unnecessary deaths in US hospitals over the 18 months from January 2005 to June 2006, largely through encouraging and helping hospitals to adopt six evidence based interventions that are known to significantly reduce harm and death when implemented reliably (box 1).56

Counting lives saved

The campaign defines a life saved as a patient who survived a hospital stay who would have died had he or she received that hospital's pre-campaign (2004) level of care.7 It calculates lives saved by comparing a hospital's mortality data for each month during the campaign with mortality data for the corresponding month in 2004. The monthly lives saved are aggregated across all months and all participating hospitals with an adjustment to account for changes in national risk of patient mortality between 2004 and the campaign period. The campaign estimates that, as of April 2006, participating hospitals had saved over 84 000 lives (based on 83% of participating hospitals submitting …