Seattle Hospital Improves Patient Safety with AHRQ Quality Indicators Toolkit

Harborview Medical Center, a level I trauma center in Seattle, used an AHRQ toolkit as a cornerstone in efforts to improve patient safety. The hospital measured a 21 percent decrease in the rate of deep vein thrombosis or pulmonary embolism (DVT/PE) among postoperative patients in under 4 years.

The hospital continues to use resources from the Toolkit for Using the AHRQ Quality Indicators to support added improvements, including a focus on patient safety measures aligned with the Centers for Medicare & Medicaid Services’ patient safety programs.

AHRQ’s QI Toolkit is available to help hospitals use the AHRQ Quality Indicators to improve patient care. The toolkit provides how-to guidance throughout the improvement process, along with an array of resources that hospitals can adapt to meet their specific needs.

Ellen Robinson, a physical therapist and clinical quality specialist, led Harborview’s improvement initiative. She credits the resources from AHRQ’s QI Toolkit for helping Harborview improve its ability to:

• Assess leadership’s readiness to change
• Apply the AHRQ Quality Indicators to hospital data
• Prioritize clinical areas and measures for improvement
• Identify and implement evidence-based clinical strategies to improve care

Using the AHRQ QI Toolkit to reduce DVT/PEs helped Harborview achieve measurable results. The chart below shows the hospital’s DVT/PE reductions.

Measure Baseline (in 2011) Post-intervention (Jan–Sep 2015) Impact (in 3 years, 9 months) Rate of DVT/PE among postoperative patients 11.7/1,000 9.3/1,000 21% decrease Rate of hospital-acquired DVT/PE 7.5/1,000 6.4/1,000 15% decrease

Harborview leaders found that using the QI Toolkit achieved broader impacts as well; it raised awareness about patient safety concerns across the hospital, improved collaboration to support patient safety, and institutionalized a standard set of patient safety protocols. Harborview is also using QI Toolkit resources to reduce:

• Pressure ulcers
• Central venous catheter-related blood stream infections
• Postoperative respiratory failures
• Postoperative sepsis
• Accidental punctures or lacerations

"We no longer have any trouble convincing people to participate in improvement efforts," Ms. Robinson noted. "The QI Toolkit helped shift the hospital culture to a greater appreciation for improvement."

Learn more about other AHRQ patient safety tools and resources.