Safety checklists offer tenfold return on investment

Using a hospital safety checklist to reduce lethal bloodstream infections in hospital intensive-care units (ICUs) not only saves lives but also thousands of dollars, according to new Johns Hopkins research.

The reduction in bloodstream infections at hospital ICUs in Michigan saved those hospitals an average of $1.1 million a year. With a tenfold return on investment, the checklist program offers hospitals a way to boost their bottom lines while improving patient safety.

"We already knew that the Michigan project saved lives and reduced infections," study leader and patient safety advocate Dr. Peter J. Pronovost, director of Johns Hopkins' Armstrong Institute for Patient Safety and Quality, said in a press release. "Now we know that by preventing infections, hospitals actually save money too."

According to the study, treating each central line-associated bloodstream infection in Michigan costs a hospital an average of $36,500. The checklist program cost about $3,375 per prevented infection between 2003 and 2005. Putting the program in place--mostly due to devoted staff time--costs a hospital an average of $161,000.

Meanwhile, the collective cost of treating the 80,000 patients that develop deadly central-line bloodstream infections each year can cost as much as $3 billion nationally, according to data from the U.S. Centers for Disease Control and Prevention.

Under the Michigan program, doctors and nurses use a "cockpit-style" checklist when placing a central-line catheter. The checklist includes five basic steps from hand washing to avoiding placement in the groin area, where infection rates are higher.

The program also includes safety education; training in how to identify safety problems, implement solutions, and measure improvements; and instructions to all team members to hold each other accountable and stop procedures if patient safety is compromised.

Insurers--public and private--end up with most of the cost savings from the checklist program, as they are relieved of the costs associated with treating the infections and subsequent complications, notes Pronovost.

For more:
- here's the Hopkins press release