Keystone Initiatives

The Keystone Project was developed in 2003 as a regional collaborative partnership that includes several Michigan hospitals, the Michigan Health and Hospital Association and patient safety experts from the Johns Hopkins University.

Through meetings and teamwork, members of the partnership share and learn from one another ways to provide better, safer patient care. The partnership's first initiative, dubbed the Keystone ICU Project, targeted intensive care units.

Hospitals participating in Keystone ICU have seen improvements like: Of the 127 participating ICUs,

  • 68 reported zero bloodstream infections or ventilator-associated pneumonia for six months or more.
  • Overall catheter-related bloodstream infections were cut in half between March and December 2004.
  • Overall ventilator-associated pneumonia rates continue to decrease.

In addition to these improvements, between March 2004 and June 2005, Keystone ICU hospital participants also reported saving 1,578 patient lives; 81,020 hospital days and more than $165.5 million health care dollars.

Because the Keystone ICU Project has been so successful, Keystone initiatives have expanded to other areas.

Keystone Initiatives in Medical Progressive Care Units (MPCUs)

The primary goal of the Keystone MPCU initiative is creating a safer environment for patients. Beaumont MPCU has initially identified seven areas of focus for safety including:

  • Reducing patient falls and weakness Identifying sepsis earlier
  • Transporting patients safely through the hospital
  • Addressing medication issues and palliative care issues
  • Creating a safe approach to non-invasive mechanical ventilation
  • Beaumont MCPUs are Michigan's first non-ICUs to participate in Keystone.

Keystone: Surgery/ORs

In partnership with Johns Hopkins University, Beaumont hospitals are the first in Michigan to apply Keystone principles to boost heighten patient safety in an operating room setting. The goal of this project is to reduce adverse events during surgery that can be directly attributed to breakdown in communication.

Beaumont will first focus on improving OR patient safety through enhanced communication. Before any surgery occurs, surgical teams gather to discuss patient operative plans, potential hazards, safety concerns, patient risks and knowledge of required equipment for the case. Beaumont places high value on improving communication between all team members. These initiatives support Beaumont's goal of making operating rooms among the safest in the world.

Keystone: Hospital-Associated Infection

Based on the success Michigan hospitals have achieved through the MHA Keystone Project, Beaumont is implementing new techniques designed to eliminate hospital-associated infections. The program starts by targeting appropriate hand hygiene, bloodstream infections and urinary tract infections.

The infection control program at Beaumont, Royal Oak has been recognized among the top 5 percent in the country with rates of health-care associated infection more than 50 percent below peer hospitals.

Keystone: Emergency Room (ER)

Beaumont, Troy was one of six hospital invited to take part in an initiative to increase patient safety in the state’s emergency centers.

With cuts to government funded health care programs and a rising number of Michigan citizens without health insurance, more and more people are seeking care in Michigan hospital emergency rooms. In response, the Michigan Hospital Association Keystone Center for Patient Safety and Quality launched in November its newest initiative, which aims to prevent harm to emergency patients by reducing boarding and overcrowding as well as wait times by using evidence-based best practices. This will ensure that the most critically ill patients are treated first and reduce the likelihood that patients will leave hospitals without treatment.

Included in the initiative are the following initiatives:

  • Implementing a comprehensive unit-based safety program to improve the culture of safety in hospital emergency departments
  • Preventing miscommunication about patient care during the transfer of a patients from the emergency departments to another location in the hospital or an external location
  • Early identification and treatment of sepsis
  • Using Lean/Six Sigma to improve the process of patient flow to address diversions, boarding and wait times

Keystone: Obstetrics (OB)

In the United States today, there are three injuries for every 1,000 births, some of which are preventable. The goals of the Keystone OB Initiatives are to implement a comprehensive unit-based safety program for improving patient safety through attitudes and practices, implement best practices and timely interventions for elective induction of labor, coordinate appropriate responses to fetal distress and coordinate a safe progression of labor.

To achieve these goals, we must evaluate our safety initiative progress, translate evidence into practice, improve culture and communication and identify and learn from mistakes.