In 2005 the Institute for Healthcare Improvement (IHI) 100,000 Lives Campaign inspired many organizations to rethink the occurrence of ventilator-associated pneumonia (VAP) and see it as a preventable disease rather than a side effect of mechanical ventilation. Sacred Heart Medical Center and Children’s Hospital in Spokane, Washington, has always been committed to patient care quality and embraced the 100,000 Lives Campaign (and subsequent 5 Million Lives Campaign) to eliminate unnecessary injuries or illnesses associated with hospitalization.

Despite emphasis on the VAP bundles for care, the pediatric intensive care unit (PICU) continued to experience increasing VAP rates throughout 2006. In alignment with the organizational goals of no preventable injuries or death, we defined the Centers for Disease Control and Prevention (CDC) benchmark of 2.9 pnemonias/1000 ventilator days as the department target. A 2-year timeline was set to reach the target, with a stretch goal of 50% reduction in the first year....

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