RESUMO
BACKGROUND: 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. BUILDING THE AGENDA FOR CHANGE: 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. THE JOURNEY CONTINUES: 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.
