Michigan ICU safety effort expands to 10 states

April 10, 2009
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A program, pioneered in Michigan, to reduce infections in the intensive care unit is expanding to 10 more states under a federal grant.

The Department of Health & Human Services’ Agency for Healthcare Research and Quality is devoting $3 million to test methods of reducing central line-associated bloodstream infections in ICU, the agency announced in February. The program will include California, Colorado, Florida, Massachusetts, Nebraska, North Carolina, Ohio, Pennsylvania, Texas and Washington.

“We are delighted that the efforts of Michigan hospitals are being applied in other states,” said Sam R. Watson, executive director of the Michigan Health and Hospital Association’s Keystone Center for Patient Safety and Quality.

Keystone worked with Johns Hopkins University School of Medicine to introduce the program in Michigan hospitals several years ago. The centerpiece is a checklist of measures for medical staff to use in ICU patients in the insertion of central venous or central line catheters. The Centers for Disease Control and Prevention estimated that 250,000 cases of central line-associated bloodstream infections occur each year in U.S. hospitals, leading to 30,000 deaths and adding more than $36,000 in costs per case, or $9 billion per year.

The program reported almost immediate and dramatic success in Michigan, reducing such infections to zero in more than half of the more than 100 participating hospitals.

Watson said that as a subcontractor, the Keystone Center will be receiving $200,000 per year over the three-year life of the grant.

“The Keystone Center will serve as the coordinator for the roll-out in all 10 states,” Watson said. “We’ll serve to work with individual states, state hospital associations and hospitals to coordinate the activity, and to help individual state hospital associations develop their own infrastructure, so in the future, for other initiatives, there will be a ready venue for deployment.”

He said Kimberly A. Sepulvado, a registered nurse who has been project coordinator for Keystone’s hospital-associated infection efforts, will be working on the federal grant, and the center is in the process of hiring someone to replace her. Michigan physicians and other staff will help the other states, hospital associations and patient safety groups to implement the program, Watson said.

The American Hospital Association’s Health Research and Education Trust is coordinating the project, and Johns Hopkins is providing clinical support, Watson said.

Watson said the Keystone Center now is working on two pilot projects, one devoted to obstetrics safety in labor and delivery and the other examining the flow of patients through the emergency room. — Elizabeth Slowik

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