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2 x 2 Mortality Matrix for Hospitals Without an Intensive Care Unit
This tool helps provide a clearer understanding of local conditions that may contribute to mortality in hospitals without critical care units.
A comparison of antecedents to cardiac arrests, deaths and emergency intensive care admissions in Australia and New Zealand, and the United Kingdom – the ACADEMIA study
Data obtained from 90 hospitals over a three-day period confirmed that antecedents are common before death, cardiac arrest and unanticipated ICU admission (the most common were hypotension and a fall in Glasgow Coma Scale).
A modern paradigm for improving healthcare quality
This publication describes four approaches to quality improvement: individual problem solving, rapid team problem solving, systematic team problem solving, and performance improvement.
A Nationwide Quality Improvement Project to Accelerate Ghana’s Progress Toward Millennium Development Goal Four
The authors describe the successes to date of a rapid, national scale-up quality improvement intervention to accelerate the achievement of Millennium Development Goal Four (reduce maternal and infant mortality) in Ghana, based on IHI's work in Ghana as part of the Project Fives Alive! initiative.
Achieving the HIV and AIDS National Strategic Plan: A practical calculator for local target setting in district health facilities
Local health leaders in areas with a high burden of HIV/AIDS lack simple tools to assess the need for adequate HIV/AIDS services. This paper and accompanying calculator provide a method to leverage available data and set targets for local HIV/AIDS services.
An approach to rapid scale-up: Using HIV/AIDS treatment and care as an example
This white paper, co-authored by the WHO and IHI, describes how health care providers in resource-poor settings can apply operations research principles and collaborative improvement methodology to introduce and rapidly spread health care interventions.
An evaluation of the evidence base related to critical care outreach teams—2 years on from Comprehensive Critical Care
This article contends that even though many hospitals have implemented measures listed within the Comprehensive Critical Care report published two years ago, there is still little evidence to suggest these measures are improving patient outcomes.
Attributable morbidity and mortality of catheter-related septicemia in critically ill patients: A matched, risk-adjusted, cohort study
A matched, risk-adjusted cohort study to determine the attributable risk of death due to catheter-related septicemia (CRS) in critically ill patients when taking into account severity of illness during the ICU stay but before CRS.
Author in the Room: Bariatric Surgery Mortality Among Medicare Patients
November 2005 | A discussion with the author of the JAMA article "Early Mortality Among Medicare Beneficiaries Undergoing Bariatric Surgical Procedures."
Author in the Room: Medical Team Training and Surgical Mortality
December 2010 | A discussion with the author of the JAMA article "Implementation of a Medical Team Training Program and Surgical Mortality."
Beyond expectations: Part 1
The Institute for Healthcare Improvement estimates that hospitals participating in the 100,000 Lives Campaign saved more than 122,300 lives in 18 months.
Beyond expectations: Part 2
This second article of a two-part series describes how nurse leaders and other members of quality improvement teams participating in IHI's 100,000 Lives Campaign were able to reduce mortality in their hospitals.
Building Rapid Response Teams
Two hospitals successfully implemented Rapid Response Teams — teams that can quickly respond to a patient and assess or even transfer the patient in minutes rather than hours — and reduced adverse events and mortality rates in both hospitals as a result.
Capacity planning: Knowing the score
This article describes how a modified early warning score (MEWS) can be obtained from readily available data.
Cape Town, South Africa, Improves the Transfer of Patient-Specific Health Information from 4 Percent to 80 Percent
In Cape Town, South Africa, a simple change improves the transfer of information about the mother's HIV status, a critical piece of information in customizing care for the newborn.
Care Model and Improvement Package: Maternal and Neonatal Mortality Reduction Collaborative in Malawi
This document describes the key elements of an ideal model of obstetric care and suggests tests of change for improving the care within hospitals participating in the Maternal and Neonatal Mortality Reduction Collaborative in Malawi.
Challenges for routine health system data management in a large public programme to prevent mother-to-child HIV transmission in South Africa
This paper assesses the completeness and accuracy of routine PMTCT data submitted to the district health information system in three districts of Kwazulu-Natal province, South Africa.
Change Ideas to Impact Mortality
These draft change ideas to reduce hospital mortality were tested by teams in IHI's IMPACT Learning and Innovation Community on Reducing Hospital Mortality Rates.
Clinical antecedents to in-hospital cardiopulmonary arrest
The authors of this article studied a group of consecutive general hospital ward patients developing cardiopulmonary arrest.
Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients: Antithrombotic Trialists' Collaboration
The authors used collaborative meta-analyses (systematic overviews) to determine the effects of antiplatelet therapy among patients at high risk of occlusive vascular events.
Comprehensive Unit-Based Safety in Burn ICU Reduces Mortality
A comprehensive unit-based safety program introduced in the fall of 2005 in the Burn Intensive Care Unit at Johns Hopkins Bayview Medical Center resulted in a mortality reduction of 60.2 percent in a one year period of time.
Crossing boundaries, re-defining care: The role of the critical care outreach team
This article makes a case for further study and broader implementation of critical care outreach teams within the NHS health care system in the United Kingdom.
Defeating Sepsis: 25 Percent by 2009
The goal of the Surviving Sepsis Campaign is to reduce the risk of dying from sepsis by 25 percent by 2009. Forty-one countries are participating in this international collaborative effort to improve the treatment of sepsis and reduce the high mortality rate associated with the condition.
Developing strategies to prevent inhospital cardiac arrest: Analyzing responses of physicians and nurses in the hours before the event
This article describes a study which attempted to determine: a) the frequency of premonitory signs and symptoms before cardiac arrest in patients on the general medical wards of a hospital; b) any characteristic patterns in nurse and physician responses to these signs and symptoms; and c) whether cardiac arrests on the ward occur more frequently in patients discharged from the medical intensive care unit (ICU) than in other patients.
Early Goal Directed Therapy Reduces Sepsis Complications and Mortality
At PeaceHealth/St. Joseph Hospital (Bellingham, Washington, USA), a partnership between the ICU and the ED, as well as ongoing surveillance and feedback to individual providers, reduced mortality related to severe sepsis and septic shock from 41 to 50 percent in the two months prior to implementation to an average of 17 percent after implementation of the Sepsis Resuscitation and Sepsis Management Bundles.