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Methods for Reducing Sepsis Mortality in Emergency Departments and Inpatient Units
North Shore-LIJ Health System (now Northwell Health) launched a strategic partnership with the Institute for Healthcare Improvement to accelerate the pace of sepsis improvement, focusing initially on sepsis recognition and treatment in emergency departments (EDs). The health system reduced overall sepsis mortality by approximately 50 percent in a six-year period and increased compliance with sepsis resuscitation bundle elements in the EDs and inpatient units in 11 acute care hospitals.
WIHI: All Hands on Deck to Reduce C. Difficile
April 9, 2015 | Where is progress being made to reduce instances of C. difficile, and where does more aggresive work need to be done?
Understanding Bundles: An IHI Faculty Conversation
IHI faculty for the Rethinking Critical Care seminar discuss and try to clarify some important and often misunderstood points about implementing care bundles (such as the Ventilator Bundle and the Central Line Bundle).
Remeasure Lactate If Initial Lactate Was Elevated Goal
Compliance with this element in the Severe Sepsis Bundles (as part of the 6-Hour Septic Shock Bundle) is defined as the percent of patients following septic shock or lactate ≥4 mmol/L (36 mg/dl) identification for whom the lactate was repeated during the first 6 hours after presentation.
Compliance with Severe Sepsis Bundles (with the Goal of Reducing Mortality)
Measuring compliance with the Severe Sepsis Bundles will allow your team to judge how well your institution is performing in achieving the goal of 100 percent compliance with all Severe Sepsis Bundles elements.
Severe Sepsis Bundles
The Severe Sepsis Bundles include the Severe Sepsis 3-Hour Rescuscitation Bundle and the 6-Hour Septic Shock Bundle. The Severe Sepsis Bundles have been revised in conjunction with the updated 2012 International Guidelines for Management of Severe Sepsis and Septic Shock.
Reliability: Severe Sepsis Bundles
The percent of cases of severe sepsis and/or septic shock for whom all applicable Severe Sepsis Bundles elements are completed.
WIHI: No Excuses, No Slack! The Latest from the Front Lines on Hand Hygiene
March 7, 2013 | This WIHI discusses recent innovations in hand hygiene with experts from facilities that have had success in achieving nearly universal compliance.
WIHI: A Partnership to Reduce Deaths from Sepsis
January 24, 2013 | This WIHI explores how North Shore–Long Island Jewish Health System has reduced its sepsis mortality rate significantly, and what others can learn from their progress.
One Is Too Many: Viewing Infection Data from the Patient's Perspective
A surgical patient who contracted MRSA following knee replacement surgery describes the effects of the surgical site infection (SSI) on her life, and how her experience led her health care providers to make changes to prevent SSIs.
Preventing Lethal Hospital Outbreaks of Antibiotic-Resistant Bacteria
Overuse of antibiotics promotes resistance in individual hospitals and contributes to the global emergence and spread of multidrug-resistant organisms (MDROs). We know how to prevent these infections; even in patients colonized with MDROs, infection is unlikely if we adhere to established practices.
Effect of Nonpayment for Preventable Infections in US Hospitals
This study examined rates of healthcare-associated infections deemed preventable by the Centers for Medicare & Medicaid Services, such as catheter-associated bloodstream infections, catheter-associated urinary tract infections, and ventilator-associated pneumonias.
Profiles in Improvement: Katharine Luther, Vice President, IHI
IHI Vice President Kathy Luther describes her career in health care quality improvement, and how her current IHI work includes getting finance and clinicians to work together to impact cost and quality.
Using Care Bundles to Improve Health Care Quality
This IHI white paper describes the history, theory of change, design concepts, and outcomes associated with the development and use of bundles — a small set of evidence-based interventions for a defined patient population and care setting — and reflects on learning over the past decade.
Perceived Impact of the Medicare Policy to Adjust Payment for Health Care-Associated Infections
The authors of this study find that the Medicare policy to cease payment for hospitalizations resulting in complications deemed preventable, including several healthcare-associated infections (HAIs), appears to drive hospital infection prevention efforts.
A Team Gives Mobility to Ventilated Patients
Patients in critical care are usually kept immobile and heavily sedated, but there’s growing evidence that mobility can help a patient's long-term recovery.
Zero VAP Rate in the ICU by Reducing Time on Sedation
Mercy Hospital (Buffalo, New York, USA) has sustained zero ventilator-associated pneumonias in the ICU by reliably implementing the IHI Ventilator Bundle, with a special focus on reducing the amount and duration of sedation for patients on ventilators in the ICU.
Measures: Prevent Central Line Infection
Care teams should measure each of the evidence-based interventions recommended by the How-to Guide: Prevent Central Line Infection.
Impact of the ventilator bundle on ventilator-associated pneumonia in intensive care unit
This article examines the adoption of the ventilator bundle elements to prevent adverse events in ventilated patients, including ventilator-associated pneumonia, in 415 ICUs in 250 US hospitals.
Passport Exclusive: Preventing Venous Thromboembolism in Hospitalized Patients
This video addresses how to accurately and effectively identify VTE risk factors and how to implement those processes in your facility.
Passport Exclusive: Reliable Practices to Prevent Hospital-Acquired Infections
In this video, IHI Director Fran Griffin, RRT, MPA, reviews principles of reliability with examples to improve infection prevention processes.
Passport Exclusive: Taking Steps to Improve Patient Mobility
This video describes the effects of early activity for patients in the intensive care unit.
Passport Exclusive: Developing, Testing, and Locally Adapting Sedation Protocols
In this video, IHI faculty member Dr. Terry Clemmer details the steps to develop and test a sedation protocol at your organization.
Passport Exclusive: The Sepsis Bundle
In this video, IHI faculty member Dr. Sean Townsend gives an overview of the Sepsis Bundle and how to get started on this work.
Passport Exclusive: Strategies to Prevent Catheter-Associated Urinary Tract Infections
In this video IHI Director Fran Griffin, RRT, MPA reviews the four recommended components of care and the supporting evidence for improvement outlined in the Prevent Catheter-Associated Urinary Tract Infections How-to Guide.