The 100 000 Lives Campaign

Abstract

AHALF DECADE HAS ELAPSED SINCE THE INSTITUTE OF Medicine released2 landmarkreportsonhealthcare safety and quality, To Err Is Human and Crossing the Quality Chasm. Those studies helped articulate a broad agenda for quality improvement in health care, and examples of success on a small scale are numerous. However, the collective impact of improvement work has been far below the potential envisioned by the Institute of Medicine. Health care can benefit now from a new sense of urgency, with levels of discipline and pace akin to those of a political campaign. Political campaigns cannot afford patience. Political campaign professionals often cite the rule: “Some is not a number; soon is not a time.” A campaign works with a firm target: 50% plus one: the number of votes needed to win— one less is not enough—and a firm deadline: election day. To quicken the pace of quality improvement in health care, the Institute for Healthcare Improvement (IHI) in December 2004 launched the 100 000 Lives Campaign—a national initiative with a goal of saving 100 000 lives among patients in hospitals through improvements in the safety and effectiveness of health care. For operational purposes in the campaign, a “life saved” is defined as a patient successfully discharged from a hospital who, absent the changes achieved during the campaign, would not have survived. Arbitrarily, IHI set a deadline of June 14, 2006, for achieving that goal, precisely 18 months after the announcement of the campaign at the IHI’s 16th Annual National Forum on Quality Improvement in Health Care. All of the nation’s 5759 hospitals have been invited to join through a simple enrollment process, explained on the IHI Web site (available at http://www.ihi.org), and they have been requested to acknowledge publicly their involvement, regularly sharing their progress in reducing mortality. How can US hospitals possibly save 100 000 lives by June 14, 2006? The campaign proposes that US hospitals implement as many as possible of 6 highly feasible interventions for which efficacy is documented in the peer-reviewed literature and is reflected in standards set by relevant specialty societies and government agencies. Campaign Interventions