Hospitals join life-saving campaign

In 2001, a Spokane doctor fused bones in Steve Rudd’s left foot. But it was his right foot that needed the operation.

In 2004, a woman died after she was injected with a toxic antiseptic solution rather than a dye during an aneurism procedure in Seattle.

And last summer, Spokane resident Jeffrey Girtz died a year after a doctor removed the wrong adrenal gland.

A national campaign to put an end to medical errors like these is gaining steam. On Tuesday, the Washington state Hospital Association announced that all 97 Washington hospitals have agreed to participate in the 100,000 Lives Campaign, an effort by the Cambridge, Mass.-based Institute for Healthcare Improvement. It’s the second state, behind Vermont and its 14 hospitals, to enroll 100 percent of its medical centers in the program.

By taking part, the hospitals agree to implement one or more of six initiatives. Within each initiative are procedures for reducing errors, infections and other complications, such as not shaving patients before surgery, angling a bed between 30 and 45 degrees for patients on ventilators to reduce the chance of contracting pneumonia and giving antibiotics to patients an hour before surgery.

Nationally, more than 2,200 hospitals – or about one-third of all U.S. hospitals – have enrolled in the program. Kootenai Medical Center in Coeur d’Alene is among them.

“People have really bought into it,” said Cassie Sauer, spokeswoman for the hospital association. “It’s really well researched and documented that it works.”

In return, the institute asks hospitals to report their monthly death rates. Specific mortality data for each hospital won’t be made public, but the institute will publish a total death rate for all participating hospitals.

It’s estimated that 44,000 to 98,000 patients die each year because of medical errors in the United States. The campaign’s goal, as ambitious as it sounds, is to eliminate all of those deaths.

While medical professionals have launched similar efforts in the past, the 100,000 Lives Campaign’s practices are simple and less expensive than previous programs, Sauer said.

One of the six practices encouraged by the campaign is assembling a “rapid response team” of nurses and doctors to assist a patient when they show signs of failing health but aren’t necessarily crashing.

Normally, that kind of medical response doesn’t occur until the patient’s heartbeat or other health indicators take a nose dive.

“It can be based on a gut feeling,” Sauer said. Nurses, custodians, receptionists or any staff members are encouraged to summon the team if they notice a patient in trouble.

Kadlec Medical Center in Richland formed a similar team six months ago, but called it the Rapid Assessment Team. The “RATs” include a critical care nurse, a respiratory therapist and a nursing supervisor.

The team has sweat shirts with embroidered cartoon rats. The logo appears on signs at the hospital, too, asking staffers to “call the rat” if they suspect a problem, Director of Patient Care Services Diane Sanders said.

“We deliberately chose the RAT team as something fun for our staff to remember,” she said.

Fun, but effective. Sanders estimates that the number of “codes,” or crashing patients, outside the 153-bed hospital’s critical care unit has dropped 10 percent to 15 percent since the RAT team was launched.

Ginger Cohen, vice president and chief clinical officer for Deaconess Medical Center, trained at the Institute for Healthcare Improvement in March and brought back an enthusiasm for the campaign to the hospital.

“It has drawn national attention to practices that physicians have already employed,” she said. “Now we’re all measuring it. We’re all watching how the group of initiatives is impacting the patient.”

Deaconess is creating a rapid response team now and has begun two of the campaign’s other initiatives.

Washington medical centers began taking safety measures before the 100,000 Lives Campaign launched.

For instance, physicians had agreed to begin writing “yes” or drawing an X on limbs that need surgery – not on the limbs that are supposed to be ignored, Sauer said.

Since September, St. Luke’s Rehabilitation Institute has barcoded every drug given to patients. Before a patient receives a medication, a computer checks the patient’s account number to make sure the correct drug and the correct dose is being administered.

“If the account number and the medicine don’t match up, it gives you warnings and bells,” said clinical documentation project coordinator Terry Basham.

Basham said no particular incident prompted St. Luke’s to adopt the Bedside Medication Verification system. It just made sense.

“I don’t see how we ever did it the old way,” especially considering how common it is for patients to be on 10 or 12 different drugs, Basham said.

But wouldn’t the medical disaster be worse if a glitch in the computer system failed to detect bad drug interactions or if a programming error skewed doses, affecting several patients instead of just one? Basham said he has faith that that wouldn’t happen.

Patients also play a role in safe hospital stays, Sauer said. The hospital association is producing a flier for patients with tips on reducing infections and other common complications.

The flier encourages patients to ask their visitors to wash their hands, to write down questions for their doctors ahead of an exam, and to tell their doctors all the medications they’re taking – including vitamins and herbal supplements.

Sauer acknowledged that it’s sometimes uncomfortable to ask a well-meaning visitor to wash their hands or stay away if they’re sick.

But, “If patients have that information written down (on the flier) they can show it to friends and family and have some back up,” she said.