Henry Ford Health System's Bold Goal to Cut Harm in Half

All hospitals have patient safety programs meant to reduce harm. Henry Ford Health System in Detroit took a more blunt approach in 2007: cut harm by 50%.

The board of the five-hospital health system—the 2011 recipient of the Malcolm Baldrige National Quality award—decided to launch a "No Harm" program under the guiding principle that "the highest priority of our quality work is to become a harmless organization." The system's leadership set a quantitative goal to reduce events of harm to patients by 50%. From 2008 to 2010, HFHS reduced system-wide harm events by 25%, and extended the program to 2013.

Register Today: Four Steps to Lasting Clinical Excellence

Live Simulcast from Henry Ford Health System: Learn how Baldrige-winner Henry Ford Health System has become a model for delivering high-quality healthcare at the HealthLeaders Media Rounds event, May 1. 

The goal of 50% was not just arbitrary. It was meant to be a number big enough to be reachable but also create a sustaining momentum for the organization.

Having a system-wide goal creates a benchmark, and an expectation of staff members, says Jennifer Ritz, manager for quality improvement in surgical services and a member of the system's No Harm steering committee.

"I can tell you that 50% is a big goal, and there's a lot that goes into that calculation," Ritz says. "But I think what is so unique for us is that we go way beyond those specific metrics that we're measuring for harm reduction. We don't just do the metrics that are in the No Harm campaign. We take it further. Things snowball and we look at projects and we don't just say, ‘Okay, we're going to jump into this initiative because it will help us reduce harm and help us get to that end goal.' We look at prioritization and what is the most urgent area that we need to be focusing on right here and now to reduce the most harm."

The goal itself has a motivational power, but so too does the definition of harm to patients, which the Henry Ford campaign expanded. Harm itself was defined as:

"Any unintended physical injury resulting from or contributed to by medical care (including the absence of indicated medical treatment) that requires additional monitoring, treatment, or hospitalization, or that results in death. Such injury is considered harm whether or not it is considered preventable, resulted from a medical error, or occurred within a hospital."

Having such a broad definition of harm was an intentional choice. It ensured that quibbling over the definition of "preventable" was not going to be a barrier, says James Kalus, PharmD, senior clinical pharmacy manager and a member of the No Harm steering committee.

"From a clinical standpoint, you can always argue that something is not preventable," Kalus says. "From a pragmatic standpoint, if you say that you're only going to target preventable harm or you say that there's a difference between preventable and non-preventable, then you're also setting yourself up that zero is never the goal. If you say everything is preventable, then theoretically you can target a lower number."

In just a few years, the No Harm campaign has allowed Henry Ford to move the safety needle in large and small ways. Comparing the first six months of the campaign (January-June 2008) for the last six months of 2011, Henry Ford Hospital recorded the following improvements:

• Overall harm has dropped 32%, which translates to 189 fewer harm events a month
• Infection-related harm has dropped by 41%
• Medication-related harm has dropped 43%
• Falls have dropped 13%
• Pressure ulcer–related harm has dropped 21%

Join host Henry Ford Health System's top leaders on May 1 for an interactive live and simulcast deep dive into the new fundamentals for patient safety, readmissions, integration, and process improvement.