Statewide Efforts to Improve Care in Intensive Care Unit

描述：（由申请人提供）在美国每年有超过500万人患有可预防的发病率和死亡率;消耗了大约30%的急性护理费用（每年1800亿美元）。以前的研究表明，几乎每个ICU患者都会遭受潜在的危及生命的不良事件。为了减少这种情况，我们必须了解什么是坏的，并修复它。我们假设，我们可以提高病人的安全;改善安全文化;并减少ICU死亡率，血流感染，吸入性肺炎和ICU住院时间。为了实现这一目标，我们将与拥有130多家密歇根医院的密歇根医院协会合作，在一批医院中实施安全计划和其他干预措施。本项目的具体目的是实施和评价：（1）包括ICU安全报告系统在内的综合单元安全计划的影响;（2）改善ICU沟通和人员配备的干预措施的影响;（3）减少/消除ICU导管相关血流感染的干预措施的影响;（4）干预措施对改善IC通气患者护理的效果;（5）干预措施对降低ICU死亡率的效果。为了实现这些目标，我们将为MHA制定干预措施，然后MHA将与密歇根州的医院互动，以实施这些干预措施。医院必须成立一个团队，包括一名高级管理人员（副总裁或以上）、一名ICU主任或ICU医生、一名ICU护士或护士经理以及一名部门管理人员，负责收集所需数据，并每年参加2次会议和2次电话会议。所有团队将致力于具体目标1，然后每6个月选择一个其他具体目标。在为期两年的项目结束时，每个团队都将实现所有5个具体目标，并能够相互指导。该项目的成功完成将导致整个国家的患者安全的显着改善。

DESCRIPTION: (Provided by the Applicant) Over 5 million people who suffer preventable morbidity and mortality are admitted annually in the U.S.; consuming about 30 percent of acute care costs ($180 billion annually). Previous studies suggest that nearly every ICU patient suffers a potentially life threatening adverse event. To reduce this, we must learn what is broken and fix it. We hypothesize that we can improve patient safety; improve safety culture; and reduce ICU mortality, blood stream infections, aspiration pneumonia and ICU length of stay. To accomplish this, we will partner with the Michigan Hospital Association, whose has over 130 Michigan hospitals, to implement a safety program and other interventions in a cohort of hospitals. The specific aims of this project are to implement and evaluate the: (1) impact of the Comprehensive Unit-based Safety Program that includes the ICU Safety Reporting System; (2) effect of an intervention to improve communication and staffing in ICUs; (3) effect of an intervention to reduce/eliminate catheter related blood stream infections in ICU s; (4) effect of an intervention to improve the care of ventilated IC patients; and (5) effect of an intervention to reduce ICU mortality. To implement these aims, we will develop interventions for MHA who will then interact with Michigan hospitals to implement these interventions. Hospitals must commit a team--including a senior executive (vice-president or above), an ICU director or ICU physician, ICU nurse or nurse manager, and a department administrator--to collecting required data and attending 2 meetings and 2 conference calls/year. All teams will work on specific aim 1 and then choose one of the other specific aims every 6 months. By the end of the two year project, each team will have implemented all 5 specific aims and able to coach each other. Successful completion of this project will lead to significant improvements in patient safety across a state.