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Tiny Midwest Hospital Takes Big Strides Toward Lower Patient Deaths


St. Peter Community Hospital in Minnesota is a small health care facility that has become a model for other hospitals across the United States. In just 18 months, the hospital has reduced infections and cut the death rate among its patients by 60 percent. St. Peter is one of 3,000 U.S. hospitals taking part in the so-called 100,000 Lives Campaign, the first-ever national initiative to help patients survive their hospital stays.

With just 17 beds, St. Peter Community Hospital is quite small by U.S. standards, but Medical Director Dr. Benjamin Chaska says the suburban Minneapolis facility faces many of the same challenges as larger, urban hospitals. "It's so complex to take care of patients," he says. "With all the different caregivers, all the different diseases, all the different drugs, mistakes are made. That actually turns out to be quite challenging."

Dr. Chaska says in the late 1990s, the Institute of Medicine studied the problem of medical mistakes nationwide. "There were 100,000 people in the United States each year that were harmed or even died from health care that wasn't delivered correctly."

Dr. Chaska says that in an effort to improve its medical services and do a better job of saving patients' lives, St. Peter Hospital in 2004 joined the 100,000 Lives Campaign. The initiative, sponsored by the private Institute for Healthcare Improvement, aims to save the lives of at least 100,000 hospital patients by reducing in-hospital infections and medical errors.

Dr. Chaska says the initiative at St. Peter targeted several problem areas, from infections in heart patients to surgical mishaps. "We took on the issue of reducing the errors in the care of acute myocardial infarction for in-patients and emergency patients, preventing adverse drug reaction from occurring, responding rapidly with patients who are on the verge of becoming unstable or who have become unstable, preventing…infections, and preventing surgical errors," he says.

In many cases, Dr. Chaska adds, major improvements in care have required only minor changes in procedure. For example, the hospital stopped using razor blades to shave the skin around surgical sites and switched to electric shavers. They also started using surgical gowns equipped with air hoses that warm up patients before and during surgery.

In other cases, the changes meant new hospital routines. "For preventing adverse drug events," he explains, "we really focused on 'medical reconciliation,' which is making sure that everybody involved with the patient care and the patient are all agreed and understand what the patient actually is taking as compared to what the doctor thinks they might be taking."

The hospital also set up a team to respond rapidly to patient urgencies. "So if the person's blood pressure is too high, we were able to intervene before he had a stroke," Chaska says.

The changes instituted at St. Peter during the 100,000 Lives Campaign had a profound impact on the quality of the hospital's medical care. "We eliminated over 90 percent of the infections," Chaska says. "We've had no unexpected death in our hospital since January 1st, 2005. That means that everybody that came here expecting to go home alive did."

St. Peter's chief executive officer Colleen Spike says taking part in the 100,000 Lives Campaign was a significant learning experience. "There was a lot of education that went on for the nursing staff," she says, "to make sure that the care is delivered all the time in the same manner in the same way no matter who is delivering that care."

St. Peter Community Hospital is the smallest facility in the country to make the 100,000 Lives Campaign's list of 100 mentor hospitals. "Being a mentor hospital is voluntary. We ask for hospitals that have done good work to raise their hands and tell their stories, to make themselves available to others," says campaign spokesman Joe McCannon. "I think that St. Peter is a great example of a smaller hospital that offers a model for other peer hospitals."

The 100,000 Lives Campaign has also been an excellent way to educate patients on how to improve the hospital care they receive. "The most important thing is an informed patient," says Dr. Samantha Collien, Vice President of HealthGrades, an independent health care rating company. She advises patients talk to their doctor, the nursing staff and anybody who enters their room. "Ask them to wash their hands, to repack your medication, to explain 'Why am I being given that pill?' That's going to make everyone really vigilant about your care because you're putting them on notice that you're keeping track."

The original goal of the 100,000 Lives Campaign was to save 100,000 lives over a period of 18 months. Campaign spokesman Joe McCannon says that when this initial phase ended last June, 122,000 lives had actually been saved. On Dec. 12, the Institute of Health Care Improvement will launch the campaign's second phase. The hope is that St. Peter and other participating health facilities will continue to successfully reduce infection and mortality rates and set higher standards for hospitals across the nation.