how wise investments in research can save lives and reduce health care costs
DESCRIPTION
Dr. Peter Pronovost of the Johns Hopkins University presented this material at AcademyHealth's 2012 Hill briefing entitled "Health and the Deficit: Using Health Services Research to Reduce Costs and Improve Quality."TRANSCRIPT
Peter Pronovost, MD, PhD, FCCM
Johns Hopkins University
How wise investments in research can
save lives and reduce healthcare costs
CLA-BSI Rate for All ICUS at JHH: 1998 - Q2 2012
1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
All ICUs 11.8 7.51 6.86 7.90 4.24 2.53 2.25 2.33 2.73 1.67 1.34 1.22 1.59 0.88 0.90
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1.00
2.00
3.00
4.00
5.00
6.00
7.00
8.00
9.00
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11.00
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13.00
CL
A-B
SI
Rat
e P
er
1,0
00 C
L. D
ays
CLA-BSI Rate for all Michigan ICUs
2004-2012
Impact of MI project on hospital mortality
for Medicare Patients Lipitz: BMJ 2011
0.7
0.8
0.9
1
1.1
Pre-implementation (12months: Oct 02 - Sept 03)
Project Initiation (5 months:Oct 03 - Feb 04)
Implementation (12 months:Mar 04 - Feb 05)
Post-implementation (12months: Mar 05 - Feb 06)
Post-implementation (12months: Mar 06 - Dec 06)
Study Group Adjusted OR Comparison Group Adjust OR
Ad
just
ed
Od
ds
Rat
io
CLA-BSI rates from 1100
Hospitals from 44 states
Armstrong Institute for Patient Safety
and Quality
7
AIRPLANES
Armstrong Institute for Patient Safety
and Quality
8
Hospitals in general, and
especially ICUs
Current Version – Worse Early 1980’s
What Might you Do
• Support Health Services Research
• Fund the development, implementation
and spread of safety programs
• Support the development of outcomes
researchers and safety leaders
• Fund Learning Labs to create an ICU
system
10/25/2012 Armstrong Institute for Patient Safety
and Quality
10
Berenholtz SM, Pronovost PJ, Lipsett PA, Hobson D, Earsing K, Farley, JE, Milanovich S, Garrett-Mayer E, Winters
BD, Rubin HR, Dorman T, Perl TM. Eliminating catheter-related bloodstream infections in the intensive care unit.
Crit Care Med 2004;32:2014-2020.
Pronovost PJ, Goeschel CA, Colantuoni E, Watson S, Lubomski LH, Berenholtz SM, Thompson DA, Sinopoli D,
Cosgrove S, Sexton JB, Marsteller JA, Hyzy RC, Welsh R, Posa P, Schumacher K, Needham D. Sustaining
reductions in catheter related bloodstream infections in Michigan intensive care units: Observational study. British
Med J 2010;340:c309.
DePalo VA, McNicoll L, Cornell M, Rocha JM, Adams L, Pronovost PJ. The Rhode Island ICU Collaborative: A
model for reducing central line-associated bloodstream infection and ventilator-associated pneumonia statewide.
Qual Saf Health Care 2010;19:555-561.
Berenholtz SM, Pham JC, Thompson DA, Needham DM, Lubomski LH, Hyzy RC, Welsh R, Cosgrove SE, Sexton
JB, Colantuoni E, Watson S, Goeschel CA, Pronovost PJ. An intervention to reduce ventilator-associated pneumonia
in the ICU: Collaborative cohort study. Infect Control Hosp Epidemiol 2011, in press.
Sexton JB, Berenholtz SM, Goeschel CA, Watson S, Holzmueller CG, Thompson DA, Hyzy RC, Marsteller JA,
Schumacher K, Pronovost PJ. Assessing and improving safety climate in a large cohort of intensive care units. Crit
Care Med Feb 2011.
Lipitz-Snyderman A, Steinwachs D, Needham DM, Colantuoni E, Morlock LL, Pronovost PJ. Impact of a statewide
intensive care unit quality improvement initiative on hospital mortality and length of stay: Retrospective comparative
analysis. Brit Med J 2011;342:d219.
Pronovost, PJ, Marsteller JA, Goeschell CA. Preventing Bloodstream Infections: A Measurable National Success
Story: Health Affairs 2011;20:628-634
Dixon-Woods, M, Bosk, C, Goeschel CA, Pronovost PJ. Explaining Michigan: Milbank Quarterly 2011
Selected References