​This improvement story originally appeared in IHI's 2006 Progress Report.

At Swedish Medical Center in Seattle, Washington, staff members have mounted a full court press on mortality in all three hospitals in its network, enhanced by lessons learned during an IHI Collaborative on improving critical care and as a member of IHI’s IMPACT network. The lessons have been well applied: the unadjusted mortality rate at Swedish dropped from an already low 2.1 percent in 2001 to 1.7 percent in mid-2005.

Swedish’s success at reducing needless deaths can be attributed to many ideas learned from IHI, says June Altaras, RN, BSN, Clinical Manager of four ICUs. “We’ve implemented the Ventilator Bundle, the Central Line Bundle, multidisciplinary rounds, and the Rapid Response Team,” she says. “We are also about to roll out the Sepsis Bundle.”

Altaras says the “small test of change” approach to improvement has revolutionized the culture at Swedish, which has always been quality-focused, but is able now to more effectively harness the expertise of front-line staff in making change. “We keep testing changes until we find a reliable process, and they love that. They love being listened to.”

Swedish’s Vice President of Quality Integration and Improvement, Judy Morton, says that staff members have launched several other initiatives using IHI’s improvement techniques. “Our stroke program, which just won the JCAHO Codman Award, developed a stroke bundle,” she says. “That’s a wonderful example of transferring a change concept.”