Eliminating bloodstream infections in the state of Michigan
The Keystone ICU project
The team from Johns Hopkins University led by Professor Peter Pronovost developed an intervention which was successful in decreasing the incidence of bloodstream infections. It consisted, among other things, of a five-item checklist to prevent the most common causes of infection, as well as a comprehensive change management strategy involving input and leadership from ICU staff and management.
One hundred and eight ICUs participated in the study, The median rate of catheter-related bloodstream infection per 1 000 catheter-days decreased from 2.7 infections at baseline to 0 at 3 months after implementation of the study intervention.
The programme has saved nearly 1 500 lives and close to 200 million US dollars in the initial phases of the project. Moreover, the participating ICUs have sustained catheter-related bloodstream infection rates at 0%.
If the results achieved in the Keystone ICU project could be replicated in other settings, this could change the lives of hundreds of thousand of patients worldwide. WHO Patient Safety is working to develop a package of intervention tools and change management strategies based on the Michigan work and adapted to other countries and other settings.