The Challenge

The Johns Hopkins University Quality and Safety Research Group (QSRG) and the MHA Keystone Center are excited to be partnering with hospitals from across Michigan to implement a peri-operative safety program. This is challenging and important work. Our objective is that all participating institutions could know with confidence whether their surgical patients are safer a year from now than they are today. Measuring peri-operative safety, especially in surgery, poses many challenges. Our goals are to:

• Eliminate surgical site infections, by ensuring that 90% of patients receive evidence-based interventions for preventing surgical site infections
• Eliminate mislabeled specimens
• Learn from our mistakes, in particular focusing on the National Quality Forum's "Never" events (wrong site surgery and retained foreign bodies)
• Have 80% of your staff reporting positive safety and teamwork climate using a measurement instrument that is psychometrically sound.

Our work together will use a collaborative model similar to one we have used successfully with intensive care units across the country. The model includes regular conference calls between your teams and MHA Keystone Center leadership to share learning and measurement tools provided by Hopkins as well as other forms of communication (such as Podcasts). QSRG faculty will provide content for calls and tools for measurement and improvement, but the expectation is that we will create a virtual learning community much as we did with ICU's. Thus the learning will go in both directions and the spirit of sharing on behalf of what is best for patients will inform all of our efforts.

Our standard of rigorous measurement and reporting will be a hallmark of this project as it is with Keystone ICU. We will strive to minimize the burden of data collection by using data that is already collected where that is feasible, to focus on methods to improve performance, and committing to the philosophy that harm is not tenable.

This is novel work which offers the possibility of national leadership on implementation of safety improvement in the peri-operative setting. We want to gain broad input from your collective knowledge throughout this effort. The Beaumont hospitals have been beta site testing components of the program over the past year and will serve as peer leaders in this work. We are confident that as partners we can implement a program broadly in Michigan which will allow us to know with confidence that our patients are safer.