For 2009 BEACON has selected two initiatives that will be pursued BEACON-wide by all participating hospitals. Our goal is a reduction in falls and sepsis mortality. These initiatives were chosen based on input from the Key Contacts, CNO Advisory Council and the Physician Leadership Advisory Council. Both falls and sepsis result in significant risk of patient harm and mortality. Improvement in these two initiatives will provide tremendous opportunity to prevent patient injury and save lives.

Each hospital will choose at least two additional initiatives: HAPU, Stroke, Perinatal, CDAD, AMI Mortality, and Catheter Associated UTI.

About Falls:
Injuries from patient falls in hospitals are a leading cause of death among people 65 and older. Of those patients who fall, up to half may suffer moderate to severe injuries that increase the risk of premature death. The potential for falls increases with hospital stays of 19 days or longer, dependency for ambulation and lack of regular exercise. Hip fractures are the most feared complication from falls with up to 20% of people sustaining hip fracture becoming nonambulatory and many are unable to recover their ability to carry out activities of daily living.

Participating hospitals will reduce their 2007 falls with injury rate per 1,000 patient days by more than 50%, with an ultimate goal of zero falls with injury. Individual improvement goals will be determined by each facility and may vary.

Data will be obtained from Cal NOC for all facilities that have executed their CalNOC addendum.

Baseline:

2007 — 0.10 falls with injury per 1,000 patient days for BEACON hospitals that participated in CalNOC.


About Sepsis:
Severe sepsis kills approximately 30% of those who develop it and another 20% die within six months as a result of lingering damage. A prompt diagnosis and thorough treatment are necessary to saving lives.

Participating hospitals will reduce their baseline for hospital defined sepsis mortality by a minimum of 30%. . Individual improvement goals will be determined by each facility and may vary.

Hospitals will submit data on a quarterly basis for initiatives. When possible, hospitals will provide historical data to establish a baseline for improvement. Improvement will be determined by a trend line. The slope of the line from the baseline until the end of the data collection period will be used to determine if the improvement goal was successfully obtained.

Each hospital will provide their definition of sepsis and severe sepsis for their facility’s improvement data.

Baseline:
Rolling 12 months Q307–Q208 prior data or Q109 data if not previously supplied.