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Nonprofit launches plan to reduce medical errors

Effort aims to save 100,000 patients in next 18 months

The Institute for Healthcare Improvement in Boston, run by Harvard physician Dr. Donald Berwick, will try to save 100,000 patients from fatal medical errors and poor care in the next 18 months by persuading hospitals to improve in six areas.

The nation's Veterans Administration hospitals already have signed on, and Blue Cross and Blue Shield of Massachusetts donated $3 million to the effort.

Numerous organizations and government agencies have developed ways for hospitals to reduce dangerous medical errors and improve quality of care and are publicly rating hospitals' efforts. But the institute's program is the first to set a specific goal of lives saved over a set period, and it has attracted a prestigious group of supporters. The institute's measures are extremely specific, providing a checklist, for example, of six things hospitals can do to prevent intensive care patients on ventilators from developing pneumonia.

"Everyone is in favor of safety," said Dr. Lucian Leape, a Harvard School of Public Health professor and nationally known patient-safety researcher. "What we really need is a set of concrete specific goals to move things along."

The institute, a nonprofit group started by Berwick that has gained national recognition, will try to persuade more than 1,000 hospitals to adopt at least one of six safety measures by July 2006. The measures include:

Deploying a rapid response team to examine patients at the first sign that their condition has declined.

Delivering evidence-based care for heart attack patients including giving them aspirin and beta-blockers early.

Developing accurate lists of patients' medications to prevent overdoses and allergic reactions.

Preventing intravenous line infections with five steps including hand-washing.

Preventing surgical site infections with three steps including giving patients antibiotics before their operations.

Preventing pneumonia in intensive care units with measures such as elevating the head of the bed by 30 degrees.

During a news conference yesterday at the group's national forum in Florida, Berwick said the institute picked measures that are proven to improve care and save lives. He said the group estimated it could save 100,000 lives by extrapolating from studies that showed how many fatal errors these measures have prevented at various hospitals.

Blue Cross executives said yesterday that the insurer has donated $500,000 to help the institute with its campaign, and another $2.5 million for Massachusetts hospitals that incur extra costs in adopting the safety measures.

Beyond the donation, Dr. John Fallon, chief physician executive at Blue Cross, said the insurer still is working out its role in the campaign. Kaiser Permanente, a California health insurer, donated $8 million to the institute.

Berwick said several hundred US hospitals and hospital systems have signed on already, including Dana-Farber Cancer Institute in Boston, Baylor Health Care System in Texas, Tenet Healthcare Corp. based in California, and Henry Ford Health System in Michigan.

The national Catholic hospital system, Ascension Health, already has implemented some of the measures, and executives said they've significantly reduced deaths in the ICUs. The Vermont and North Carolina hospital associations have agreed to sign-up their members.

Paul Wingle, a spokesman for the Massachusetts Hospital Association, said the group needs more information before deciding whether to join with Berwick. The association noted it already has several quality-improvement projects underway.

Dr. Thomas Lee, network president for Partners HealthCare, the parent organization of two Harvard teaching hospitals, Massachusetts General and Brigham and Women's, said Partners hasn't discussed whether to join the program, but will do so soon. Lee said Partners hospitals already are implementing many of the institute's measures. "The things he is pushing for are very good things and help save lives," Lee said.

Liz Kowalczyk can be reached at

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