Michigan’s Focus on ICU Patient Safety Achieves Success

Editor’s**note:**In early January, the Michigan Health and Hospital Association announced that hospitals participating in the Keystone intensive care unit project described in the article below had temporarily halted some data collection and reporting activities in response to a federal ruling requiring hospitals to have the activities reviewed by their institutional review boards. The ruling did not affect the patient safety and quality practices described in this article.

A patient safety improvement project for intensive care units (ICUs) in 72 Michigan hospitals has had significant success in improving patient safety and patient outcomes by reducing bloodstream infections (BSIs) and ventilator-associated pneumonia (VAP), boosting team approaches to safety, and achieving senior leadership support. Called Keystone ICU, the project was implemented in 120 ICUs in October 2003 as a joint effort involving patient safety experts from Johns Hopkins Hospital (Baltimore, Maryland) and the Michigan Health and Hospital Association (MHA) Keystone Center for Patient Safety and Quality, with funding from the Agency for Healthcare Research and Quality.

The goals of the Keystone ICU project were to im-prove quality of care, enhance safety culture and staff satisfaction, and eliminate unnecessary and additional costs through best-practice and evidence-based interventions (MHA).

The early and continuous involvement of and support from leadership were a crucial component of the project's success. Keystone ICU created a strengthened sense of teamwork between executives and clinicians, provided safer care for...