Legacy Health, Portland, Oregon, USA.
Health Aff (Millwood). 2011 Apr;30(4):619-27. doi: 10.1377/hlthaff.2011.0024.
An uncomfortable truth about US health care is that medical harm and needless deaths continue to occur, even after a decade of concentrated efforts to eliminate them. However, some hospital systems are managing to improve patient safety. Legacy Health, a system with six hospitals in the Portland, Oregon, metropolitan area, engaged its entire workforce in an initiative to reduce rates of infection and mortality. Legacy staff used bundles of best practices to prevent four common health care-associated infections; reviewed deaths and revised procedures based on the findings; and included staff from different disciplines in daily medical rounds. The results were a 44.6 percent reduction in infections and a 13.5 percent reduction in mortality, as well as annual savings of more than $6.8 million for each of the first two years from the avoided costs of treating health care-associated infections. Fewer patients suffered, died, or incurred daunting copayments for hospital care. These results demonstrate that health care systems can greatly improve quality and safety and lower costs when leaders as well as front-line clinicians and staff are highly involved in improvement efforts.
美国医疗保健领域存在一个令人不安的事实，即尽管十年来一直集中精力消除医疗伤害和不必要的死亡，但此类事件仍时有发生。然而，一些医院系统正在努力改善患者安全。Legacy Health 是一家在俄勒冈州波特兰大都市区拥有六家医院的系统，它让全体员工参与了一项旨在降低感染率和死亡率的计划。Legacy 的员工采用了一系列最佳实践来预防四种常见的与医疗保健相关的感染；根据研究结果审查死亡病例并修改程序；并让不同学科的员工参与日常医疗查房。结果，感染率降低了 44.6%，死亡率降低了 13.5%，在前两年，由于避免了与治疗与医疗保健相关的感染相关的成本，每个系统每年节省超过 680 万美元。更少的患者遭受痛苦、死亡或因医院护理而产生巨额自付费用。这些结果表明，当领导层以及一线临床医生和员工高度参与改进工作时，医疗保健系统可以大大提高质量和安全性并降低成本。
