Hendrich Ann, Tersigni Anthony R, Jeffcoat Sally, Barnett Charles J, Brideau Leo P, Pryor David
Clinical Excellence Operations, Ascension Health, St Louis, USA.
Jt Comm J Qual Patient Saf. 2007 Dec;33(12):739-49. doi: 10.1016/s1553-7250(07)33089-4.
In 2002, Ascension Health, a 65-hospital nonprofit health care system, articulated a call to action to provide Healthcare That Works, Healthcare That Is Safe, and Healthcare That Leaves No One Behind. The goal is to provide excellent clinical care with no preventable injuries or deaths by July 2008. Just months from this target date, substantial reductions in events related to eight priorities for action have been documented, and at the current rate more than 2,000 lives a year are being saved compared to the baseline mortality rate.
Progress toward the goal of zero preventable injuries or deaths required transformational change. Key steps toward this change included establishing a sense of urgency, creating a guiding coalition (the clinical excellence team), and developing the Destination Statement II. Other key factors in our early success included methods of process and outcomes measurement, the formation of appropriate and diverse leadership groups comprised of primary stakeholders, methods of knowledge transfer, and the involvement and leadership of the Ascension Health Quality Committee and individual health ministry Boards.
An ongoing discussion of what "zero preventable deaths and injuries" really means has led to the identification of additional interventions to further reduce preventable injuries and deaths.
2002年，拥有65家医院的非营利性医疗保健系统阿森松医疗集团发起了一项行动号召，旨在提供有效的医疗保健、安全的医疗保健以及不落下任何人的医疗保健。目标是到2008年7月提供优质临床护理，杜绝可预防的伤害或死亡。距离这个目标日期仅剩几个月时，与八项行动重点相关的事件已大幅减少，按目前的速度，与基线死亡率相比，每年可挽救2000多条生命。
要实现零可预防伤害或死亡的目标，需要进行变革性改变。实现这一改变的关键步骤包括营造紧迫感、组建指导联盟（临床卓越团队）以及制定《目标声明II》。我们早期取得成功的其他关键因素包括过程和结果测量方法、由主要利益相关者组成的适当且多样化的领导团队的形成、知识转移方法，以及阿森松医疗质量委员会和各健康部门董事会的参与和领导。
对“零可预防死亡和伤害”真正含义的持续讨论，促使我们确定了更多干预措施，以进一步减少可预防的伤害和死亡。
