How Wise Investments in Research can Save Lives and Reduce Health Care Costs


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Dr. Peter Pronovost of the Johns Hopkins University presented this material at AcademyHealth's 2012 Hill briefing entitled "Health and the Deficit: Using Health Services Research to Reduce Costs and Improve Quality."

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How Wise Investments in Research can Save Lives and Reduce Health Care Costs

  1. 1. How wise investments in research cansave lives and reduce healthcare costs Peter Pronovost, MD, PhD, FCCM Johns Hopkins University
  2. 2. CLA-BSI Rate for All ICUS at JHH: 1998 - Q2 2012 13.00CLA-BSI Rate Per 1,000 CL. Days 12.00 11.00 10.00 9.00 8.00 7.00 6.00 5.00 4.00 3.00 2.00 1.00 - 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 All ICUs 11.8 7.51 6.86 7.90 4.24 2.53 2.25 2.33 2.73 1.67 1.34 1.22 1.59 0.88 0.90
  3. 3. CLA-BSI Rate for all Michigan ICUs2004-2012
  4. 4. Impact of MI project on hospital mortality for Medicare Patients Lipitz: BMJ 2011 1.1 1 0.9Adjusted Odds Ratio 0.8 0.7 Pre-implementation (12 Project Initiation (5 months: Implementation (12 months: Post-implementation (12 Post-implementation (12 months: Oct 02 - Sept 03) Oct 03 - Feb 04) Mar 04 - Feb 05) months: Mar 05 - Feb 06) months: Mar 06 - Dec 06)
  5. 5. CLA-BSI rates from 1100Hospitals from 44 states Armstrong Institute for Patient Safety 7 and Quality
  6. 6. AIRPLANES Armstrong Institute for Patient Safety 8 and Quality
  7. 7. Hospitals in general, andespecially ICUs Current Version – Early 1980’s Worse
  8. 8. What Might you Do• Support Health Services Research• Fund the development, implementation and spread of safety programs• Support the development of outcomes researchers and safety leaders• Fund Learning Labs to create an ICU system10/25/2012 Armstrong Institute for Patient Safety 10 and Quality
  9. 9. Selected ReferencesBerenholtz SM, Pronovost PJ, Lipsett PA, Hobson D, Earsing K, Farley, JE, Milanovich S, Garrett-Mayer E, WintersBD, Rubin HR, Dorman T, Perl TM. Eliminating catheter-related bloodstream infections in the intensive care unit.Crit Care Med 2004;32:2014-2020.Pronovost PJ, Goeschel CA, Colantuoni E, Watson S, Lubomski LH, Berenholtz SM, Thompson DA, Sinopoli D,Cosgrove S, Sexton JB, Marsteller JA, Hyzy RC, Welsh R, Posa P, Schumacher K, Needham D. Sustainingreductions in catheter related bloodstream infections in Michigan intensive care units: Observational study. BritishMed J 2010;340:c309.DePalo VA, McNicoll L, Cornell M, Rocha JM, Adams L, Pronovost PJ. The Rhode Island ICU Collaborative: Amodel for reducing central line-associated bloodstream infection and ventilator-associated pneumonia statewide.Qual Saf Health Care 2010;19:555-561.Berenholtz SM, Pham JC, Thompson DA, Needham DM, Lubomski LH, Hyzy RC, Welsh R, Cosgrove SE, SextonJB, Colantuoni E, Watson S, Goeschel CA, Pronovost PJ. An intervention to reduce ventilator-associated pneumoniain the ICU: Collaborative cohort study. Infect Control Hosp Epidemiol 2011, in press.Sexton JB, Berenholtz SM, Goeschel CA, Watson S, Holzmueller CG, Thompson DA, Hyzy RC, Marsteller JA,Schumacher K, Pronovost PJ. Assessing and improving safety climate in a large cohort of intensive care units. CritCare Med Feb 2011.Lipitz-Snyderman A, Steinwachs D, Needham DM, Colantuoni E, Morlock LL, Pronovost PJ. Impact of a statewideintensive care unit quality improvement initiative on hospital mortality and length of stay: Retrospective comparativeanalysis. Brit Med J 2011;342:d219.Pronovost, PJ, Marsteller JA, Goeschell CA. Preventing Bloodstream Infections: A Measurable National SuccessStory: Health Affairs 2011;20:628-634Dixon-Woods, M, Bosk, C, Goeschel CA, Pronovost PJ. Explaining Michigan: Milbank Quarterly 2011