A Success Story in American Health Care…

Right Here In Michigan!

The Michigan Keystone ICU Project Saved Over 1,500 Lives and $200 million by Reducing Health Care Associated Infections

One recent success story is the Michigan Keystone Intensive Care Unit (ICU) Project, a partnership between the Michigan Health & Hospital Association and Johns Hopkins University.5

The goal of the Michigan Keystone ICU Project was to make patient care safer in over 100 ICUs in the state of Michigan. The project targeted a specific type of infection that ICU patients can get while in the hospital – catheter-related bloodstream infections.

These infections are expensive and potentially lethal. They add approximately $18,000 to the cost of care when a patient contracts them, and cause 24,000 deaths per year.7

The Keystone Project sought to change clinicians’ behaviors when inserting catheters into ICU patients. To do so, the team made a checklist, measured infection rates, and changed hospital culture.

These five steps were associated with a 66-percent reduction in these infections throughout the state, saving over 1,500 lives and $200 million in the first 18 months alone.

The Keystone Project is more than the story of a simple tool like the checklist making a dramatic impact. It is the story of complex organizational change across an entire state – changing the attitudes and practices of doctors and nurses, creating incentives for cooperation, partnering with the state hospital association, and creating a social network amongst participating hospitals in Michigan to share best practices.

The lessons learned as a result of this work offer many ideas and opportunities for future initiatives to improve quality and patient safety in the United States.


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