title: Creating a physician-led quality imperative.
abstract: To emerge from a significant quality crisis, hospital administration recognized the need for physician leadership to drive improvements. A framework is presented for a physician-led Quality Summit to select best practice initiatives for implementation over 1 year. Results demonstrated statistically significant reductions in ventilator-associated pneumonia, decreasing from the first quarter 2009 baseline of 8.34 per 1000 ventilator days to 3.32 per 1000 ventilator days in second quarter 2010 (P = .0055). During the same time frame, catheter-associated urinary tract infections decreased from 4.35 per 1000 catheter days to 0.98 per 1000 catheter days (P = .0438), and severe sepsis/septic shock mortality declined from 33% to 13% (P = .0084). The customized World Health Organization Surgical Safety Checklist was used in 93% of surgeries within 1 month of adoption. Venous thromboembolism screening for adults became routine. The annual Quality Summit cycle engages physicians to introduce and spread quality improvement.
authors.affiliation: Enloe Medical Center, Chico, CA marcia.nelson@enloe.org.
authors.forename: Marcia F
authors.initials: MF
authors.lastname: Nelson
authors.affiliation: Enloe Medical Center, Chico, CA.
authors.forename: Charles S
authors.initials: CS
authors.lastname: Merriman
authors.affiliation: Enloe Medical Center, Chico, CA.
authors.forename: Peter T
authors.initials: PT
authors.lastname: Magnusson
authors.affiliation: Enloe Medical Center, Chico, CA.
authors.forename: Kristapor V
authors.initials: KV
authors.lastname: Thomassian
authors.affiliation: Enloe Medical Center, Chico, CA.
authors.forename: Alivia
authors.initials: A
authors.lastname: Strawn
authors.affiliation: Enloe Medical Center, Chico, CA.
authors.forename: Julie
authors.initials: J
authors.lastname: Martin
mesh_terms: D000328:Adult; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000517:prevention & control; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D007857:Leadership; D008505:Medical Staff, Hospital / Q000458:organization & administration*; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology / Q000517:prevention & control; D016730:Program Development; D058996:Quality Improvement / Q000458:organization & administration*; D018805:Sepsis / Q000401:mortality / Q000517:prevention & control; D014546:Urinary Catheterization / Q000009:adverse effects; D054556:Venous Thromboembolism / Q000517:prevention & control
keywords: physician engagement; process improvement; quality; safety