A potent combination of factors has helped to significantly reduce mortality at Unity Hospital in Fridley, Minnesota, part of the Allina Health System and a member of IHI’s IMPACT network. Unity’s Hospital Standardized Mortality Ratio (HSMR), a mortality metric that adjusts for multiple variables at the patient, hospital, and regional level, dropped from 113 in 2001 to 75 in 2003. The US average for those years was approximately 98 and 90, respectively.
Amy Susag, RN, Clinical Nurse Specialist, says a contributing factor in this considerable reduction was the introduction of hospitalists in the fall of 2002, and the resulting increase in continuity and communication. The hospitalists see patients “every single day and really stay on top of things,” says Susag.
Additionally, the ICU has implemented the Ventilator Bundle and significantly reduced ventilator-associated pneumonia, going as long as 448 days without a single case.
Newer initiatives include tight glucose control for all ICU patients, says Judy Hoaglund, RN, MA, ICU Nurse Manager. “Patients with two glucose readings of 150 or more are placed on insulin infusions,” she says. “We are aggressive about that.” In addition, Rapid Response Teams race to patients’ beds when nurses sense trouble, resulting in 40 percent fewer code events since they began in late 2004.
01/16/2006
