Introducing the No Preventable Harms campaign: creating the safest health care system in the world, starting with catheter-associated urinary tract infection prevention.
BACKGROUND
Endemic health care-associated safety problems, including health care-associated infection, account for substantial morbidity and mortality. We outline a regional No Preventable Harms campaign to reduce these safety problems and describe the initial results from the first initiative focusing on catheter-associated urinary tract infection (CAUTI) prevention.


METHODS
We formed a think tank composed of multidisciplinary experts from within a 7-hospital Midwestern Veterans Affairs network to identify hospital-acquired conditions that had strong evidence on how to prevent the harm and outcome data that could be easily collected to evaluate improvement efforts. The first initiative of this campaign focused on CAUTI prevention. Quantitative data on CAUTI rates and qualitative data from site visit interviews were used to evaluate the initiative.


RESULTS
Quantitative data showed a significant reduction in CAUTI rates per 1,000 catheter days for nonintensive care units across the region (2.4 preinitiative and 0.8 postinitiative; P = .001), but no improvement in the intensive care unit rate (1.4 preinitiative and 2.1 postinitiative; P = .16). Themes that emerged from our qualitative data highlight the need for considering local context and the importance of communication when developing and implementing regional initiatives.


CONCLUSIONS
A regional collaborative can be a valuable strategy for addressing important endemic patient safety problems.
Department of Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI; Hospital Outcomes Program of Excellence (HOPE) Initiative, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI; Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI. Electronic address: saint@med.umich.edu.
Sanjay
S
Saint
Department of Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI; Hospital Outcomes Program of Excellence (HOPE) Initiative, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI.
Karen E
KE
Fowler
Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, IN.
Kelley
K
Sermak
Department of Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI.
Elissa
E
Gaies
Department of Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI; Hospital Outcomes Program of Excellence (HOPE) Initiative, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI.
Molly
M
Harrod
Aleda E. Lutz Veterans Affairs Medical Center, Saginaw, MI.
Penny
P
Holland
Department of Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI; Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI.
Suzanne F
SF
Bradley
Department of Veterans Affairs Veterans Integrated Service Network (VISN)11, Ann Arbor, MI.
J Brian
JB
Hancock
Department of Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI; Hospital Outcomes Program of Excellence (HOPE) Initiative, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI; Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI.
Sarah L
SL
Krein
D055499:Catheter-Related Infections / Q000453:epidemiology / Q000517:prevention & control*; D003695:Delivery of Health Care; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000379:methods* / Q000458:organization & administration*; D061214:Patient Safety; D015995:Prevalence; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000517:prevention & control*
Collaborative; Hospital unit culture; Hospital-acquired conditions; Patient safety; Regional medical programs