Missouri Baptist Medical Center Lowers Mortality Rate to 1.95 Percent

This story originally appeared in IHI's 2007 Annual Progress Report.
Reducing hospital mortality requires the right combination of big-picture thinking and attention to small details, says John Krettek, MD, PhD, Vice President of Medical Affairs and Chief Medical Officer at Missouri Baptist Medical Center in St. Louis, Missouri.
“First,” he says, “it is vitally important that from the board level to the front-line staff, everyone must view reducing mortality as his or her job.” 
But commitment is just the beginning. Saving lives requires a relentless focus on optimizing systems and processes on every front. At Missouri Baptist, careful and continuous monitoring of the six 100,000 Lives Campaign interventions along with other clinical initiatives provides a wealth of data that help staff at all levels prioritize improvement work. “Through IHI we have tools that allow us to continually enhance our effectiveness,” says Krettek.
Krettek says that every death, every Rapid Response Team call, every Code Blue, provides important feedback. “We analyze the impact of systems, processes, or performance. This is educational, not punitive,” he says. “The idea is to identify improvement opportunities that are not yet recognized.”
Krettek, who for 20 years served as Chief of Neurosurgery, says that, for clinicians used to treating one patient at a time, it is especially gratifying to see the global impact of improvement work. “Preventing mortality is the ultimate way to help our patients.”
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