title: The clinical transformation of Ascension Health: eliminating all preventable injuries and deaths.
abstract: BACKGROUND
  In 2002 Ascension Health, a 67-hospital not-for-profit health care system, articulated a call to action to provide excellent clinical care with no preventable injuries or deaths by July 2008. It embarked on a journey of clinical transformation. Transformational change implies a much greater pace of change than that reflected in traditional, incremental change processes.
  Progressing from vision to action plan required setting the clinical transformation agenda, identifying challenges to this agenda, and establishing measurements of progress. Environmental changes that must be addressed to successfully implement a transformational change process include culture, making the business case, infrastructure investments, standardization, and how we work together.
  Improvement activities focused on eight priorities for action, including preventable mortality and areas such as adverse drug events, falls, and surgical complications. "Alpha" sites would develop the best clinical and implementation practices for eliminating the preventable adverse events related to these areas.
  
  
  RESULTS
  The observed decrease in the mortality rate among non-end-of-life-care patients was 21% (p < .001), exceeding the 15% goal set for July 2008 and corresponding to 1,200 deaths prevented across the system. The alpha sites reported initial results in June 2004, with more than 50% reductions in adverse events for all the priorities for action areas.
authors.affiliation: Clinical Excellence, Ascension Health, St Louis, USA. dpryor@acensionhealth.org
authors.forename: David B
authors.initials: DB
authors.lastname: Pryor
authors.forename: Sanford F
authors.initials: SF
authors.lastname: Tolchin
authors.forename: Ann
authors.initials: A
authors.lastname: Hendrich
authors.forename: Clarence S
authors.initials: CS
authors.lastname: Thomas
authors.forename: Anthony R
authors.initials: AR
authors.lastname: Tersigni
mesh_terms: D019033:Delivery of Health Care, Integrated / Q000458:organization & administration* / Q000592:standards; D017052:Hospital Mortality; D006801:Humans; D007400:Interprofessional Relations; D015279:Organizational Culture; D009937:Organizational Objectives; D016730:Program Development; D011785:Quality Assurance, Health Care / Q000458:organization & administration* / Q000592:standards; D012449:Safety / Q000592:standards; D014947:Wounds and Injuries / Q000517:prevention & control*