Secretary of Health and Human Services Kathleen Sebelius released the first of series of success stories in American Health Care. The inaugural report highlights the success of Michigan's Keystone Project in reducing health care associated infections across the Great Lakes State.

The story of the Keystone Project -- a partnership between Michigan Health & Hospital Association and researchers at Johns Hopkins -- should be familiar to many of our readers. Atul Gawande -- who's written an important New Yorker article on everything -- wrote an important New Yorker article on it back in December 2007. We blogged on the lessons from their accomplishments back in April 2008 and more recently on the similar success of the Billings Clinic in reducing HAIs. Still, the report does a nice job of tying it all together in the context of the broader health reform debate.

The report's authors note that while nearly 100,000 patients die each year from medical errors in the United State, measures of patient safety have actually gotten worse over the past decade. They attribute this to a rise in HAIs, which are among the top ten leading causes of death in the U.S. at a cost of $28 to $33 billion a year.

Yet, as the Keystone Project proves, simple measures can go a long way toward eliminating such infections. In particular, the project focused on catheter-related bloodstream infections, which "add approximately $18,000 to the cost of care when a patient contracts them, and cause 24,000 deaths per year." The project developed checklists to change clinician behavior. They focused making sure simple things like hand washing and disinfecting a patients skin were done, and done correctly.

The results, as depicted by HHS's graphic below, were impressive. The project saw a 66 percent reduction in the rate of such infections across the state -- saving more than 1,500 lives and $200 million. Peter Provonost -- a researcher at Johns Hopkins who helped design the program -- estimates that the return on investment to be between 200 and 400 fold.

But the Keystone Project is more than just some isolated case study. The authors write:

The Keystone Project is more than the story of a simple tool like the checklist making a dramatic impact. It is the story of complex organizational change across an entire state -- changing the attitudes and practices of doctors and nurses, creating incentives for cooperation, partnering with the state hospital association, and creating a social network amongst participating hospitals in Michigan to share best practices.

The implications for broader health reform are clear. Complex change is possible within relatively rapid periods of time. But it takes commitment from many stakeholders involved in the process. Which is why the stimulus contained $50 million in grants to help replicate the success of Michigan across the U.S. The goal is to reduce catheter related infections in hospitals across America by 75 percent over the next three years. It should be easy -- provided they put it on a checklist.