Jarman B. Which hospital is best? Newsweek International. October 30, 2006.

As health care becomes more of a global enterprise, the need for an objective measure of hospital performance has become more pressing. In this article, Dr. Brian Jarman describes why hospitals should know their hospital standardized mortality ratio (HSMR).

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Saver C. Beyond expectations: Part 2. Nursing Management. 2006 Nov;37(11):17-23.

This second article of a two-part series describes how nurse leaders and other members of quality improvement teams participating in IHI's 100,000 Lives Campaign were able to reduce mortality in their hospitals.

Saver C. Beyond expectations: Part 1. Nursing Management. 2006 Oct;37(10):36-42.

The Institute for Healthcare Improvement estimates that hospitals participating in the 100,000 Lives Campaign saved more than 122,300 lives in 18 months. This first article of a two-part series examines how the results were calculated and the impact on quality and the bottom line.

Landro L. The informed patient: Hospitals combat error at the "hand-off." The Wall Street Journal. June 28, 2006.

John Whittington, patient safety officer at OSF St. Joseph Medical Center, says the SBAR "quick briefing" model can help overcome differing communication styles, such as nurses who give long, descriptive reports and doctors who say, "just give me the headlines," and don't want a nurse's opinion. OSF started training staffers to use the SBAR communication model in 2004, offering pocket cards and laminated "cheat sheets" posted at each phone.

Wright J, Dugdale B, Hammond I, Jarman B, et al. Learning from death: A hospital mortality reduction programme. Journal of the Royal Society of Medicine. 2006 Jun;99(6):303-308.

This article describes a study in the UK which involved a before and after evaluation of a hospital mortality reduction programme. The study involved an audit of hospital deaths to inform an evidence-based approach to identify processes of care to target for the hospital strategy. The strategy included establishment of a hospital mortality reduction group with senior leadership support, and robust measurement and regular feedback of hospital deaths using statistical process control charts.

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Pryor DB, Tolchin SF, Hendrich A, Thomas CS, Tersigni AR. The clinical transformation of Ascension Health: Eliminating all preventable injuries and deaths. Joint Commission Journal on Quality and Patient Safety. 2006 June;32(6):299-308.

In 2002 Ascension Health, a 67-hospital not-for-profit health care system, embarked on a journey of clinical transformation to eliminate preventable injuries or deaths. This transformational change implies a much greater pace of change than that reflected in traditional, incremental change processes. Their improvement activities focused on eight priorities for action: JCAHO National Patient Safety Goals; preventable mortality; adverse drug events; falls; pressure ulcers; surgical complications; nosocomial infections; and perinatal safety. [This article is the first in a series.]

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Institute for Healthcare Improvement. IHI Innovation Series white paper. Reducing Hospital Mortality Rates (Part 2). Cambridge, Massachusetts: Institute for Healthcare Improvement; 2005.

IHI Innovation Series white paper

A number of hospitals working with IHI have been testing the theory that mortality can be consistently reduced through the use of a combination of evidence-based interventions, and the preliminary results generally are encouraging. This white paper presents an update on IHI's work to reduce mortality first introduced in the "Move Your Dot" white paper.

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Hillman K, Chen J, Cretikos M, et al. Introduction of the medical emergency team (MET) system: A cluster-randomised controlled trial. Lancet. Jul 2005;365(9477):2091-2097.

A study of 23 hospitals in Australia to determine whether Medical Emergency Teams (MET) — also known as Rapid Response Teams — reduce the rate of cardiac arrests, unplanned admissions to intensive care units, and deaths. Eleven hospitals functioned as usual and 12 introduced a MET system. The authors concluded that, although the introduction of the MET system led to an increase in calls to the team, it did not substantially affect the incidence of cardiac arrest, unplanned ICU admissions, or unexpected death.

Hillman K, Parr M, Flabouris A, Bishop G, Stewart A. Redefining in-hospital resuscitation: The concept of the medical emergency team. Resuscitation. 2001;48(2):105-110.

This article describes the characteristics of a Medical Emergency Team (MET), also referred to as a Rapid Response Team or Medical Response Team (MRT). Also identified are the issues to be addressed in implementing a MET program, including the development of criteria for calling the MET.

Hodgetts TJ, Kenward G, Vlachonikolis IG, Payne S, Castle N. The identification of risk factors for cardiac arrest and formulation of activation criteria to alert a medical emergency team. Resusitation. 2002;54(2):125-131.

This article describes a study that aimed to: (1) identify risk factors for in-hospital cardiac arrest; (2) formulate activation criteria to alert a clinical response culminating in attendance by a Medical Emergency Team (MET); and (3) evaluate the sensitivity and specificity of the scoring system. A multivariate analysis of cardiac arrest cases identified three positive associations: abnormal breathing, abnormal pulse, and abnormal systolic blood pressure. Risk factors were weighted and tabulated, and formulated into a table of activation criteria for alerting a clinical response.