A documentary scheduled to air Thursday on WQED-TV is a good reminder of why the community rallied around the Pittsburgh Regional Health Initiative at its founding and also provides a good occasion to look at how far it has come since those early days.

		Karen Wolk Feinstein, Ph.D., is president and chief executive officer of the Jewish Healthcare Foundation and the Pittsburgh Regional Health Initiative.

"Good News: How Hospitals Heal Themselves" was made several years ago, but its message is as timely as it was then: The health-care industry is filled with highly trained, well intentioned clinicians whose work is too often sabotaged by a delivery system in need of radical reform -- or, better yet, re-engineering.

These days, talk of quality engineering, which is at the heart of our mission, is the subject of many conferences in health care, and regional health-care coalitions akin to the Pittsburgh Regional Health Initiative are sprouting across the country.

But few organizations -- if any -- were even thinking about the kind of vision we as a community set out to pursue when the Pittsburgh Regional Health Initiative began.

The health initiative was born as a communitywide coalition of health-care stakeholders nearly a decade ago out of the belief that our region could and should set a standard for the nation in improving the safety and quality of health care.

At the time, few people realized that medical errors result in 100,000 hospital deaths each year and that infections contracted because of hospital stays are responsible for 100,000 more. Moreover, even a couple of years after our organization began and the Institute of Medicine reported this appalling fact, almost no one in health care thought that these errors could be eliminated --no matter how hard we might try.

That made the very idea of our experiment extraordinary -- in its foresight, its audacity and, to an extent, in its naivety -- because we said otherwise.

The Pittsburgh Regional Health Initiative has been like "The Little Engine that Could."

After gaining support from all of the region's health-care stakeholders to pursue this vision, we embarked on some ambitious undertakings.

Notable among them, the organization rallied infection control experts from southwestern Pennsylvania into a demonstration that remains the largest of its kind in the nation; we helped more than 30 of the region's hospitals reduce the incidence of a lethal, hospital-acquired bloodstream infection by 68 percent. The results, audited by the Centers for Disease Control and Prevention, were reported in the Journal of the American Medical Association this year.

Our experiment may not have reached zero infections, but it did yield some essential truths -- a couple of which are only now gaining acceptance nationally.

First, we affirmed that striving for zero medical errors or zero hospital-acquired infections is the only tenable goal. Any outside benchmark or arbitrary target would not have pushed our experiment nearly as far as it went. And we can point to at least one hospital -- Allegheny General Hospital -- that got close to zero and sustained and spread its momentum to other clinical units and to other kinds of infection.

We also began affirming the premise that originally inspired us: that quality is the most enduring cost containment strategy for health care.

Pittsburgh Regional Health Initiative continues to support work demonstrating that there is an incredibly strong "business case" for pursuing quality. Our work with Dr. Rick Shannon at Allegheny General, which has become almost legendary in health-care and health policy circles, determined that the single hospital-acquired bloodstream infection that was the subject of our first demonstration adds upwards of $14,000 to the cost of care for a single patient -- nearly $1 million annually at AGH, where we helped analyze the financial impact.

And, finally, we learned that to achieve quality, there needs to be passionate clinical leadership and appropriate tools.

About six years ago, we introduced the tools with a quality engineering curriculum based the Toyota Production System.

The adaptation of the Toyota methods is known as Perfecting Patient Care. We teach this methodology in a four-day program known as PPC University and in a shorter version known as PPC 101. In a nutshell, Perfecting Patient Care teaches clinicians to identify and analyze errors in real time, at the point of care, and to rapidly adopt countermeasures to ensure that the same errors don't happen again. As error-free processes are adopted and standardized, care is perfected.

I'd be misleading you to suggest that these principles have been wholeheartedly embraced, much less widely employed in health care. But I'd be shortchanging Pittsburgh Regional Health Initiative's influence and accomplishment if I didn't also point to real progress. Not only has the organization been tapped to help a number of kindred coalitions find their footing in other regions, but also talk of safety, quality and the same systems principles that were used to re-engineer manufacturing are now a large part of the national conversation in health care.

We also have begun identifying and supporting passionate clinical leaders who want to use these tools to repair a troubled system.

With grants from the Jewish Healthcare Foundation, eight physician leaders, whom we call Physician Champions, are demonstrating the value of quality engineering not just in infection control, but also in pathology, cardiac care and care for chronic illnesses such as diabetes.

A story in the Wall Street Journal last month explored our work supporting a UPMC Health System project to reduce pathology errors. That project is part of a groundbreaking national collaboration among nine major medical centers, including Michigan's Henry Ford Health System.

For the first time, we also have expanded into long-term care, a part of the continuum of care that cries out for tools not just to improve quality, but also to address one of the most serious problems nursing homes confront: employee turnover.

Thursday's documentary doesn't capture that work or any of Pittsburgh Regional Health Initiative's newer projects. But it does capture the essence of a mission that remains the same as when the film was made. As it was then, Pittsburgh Regional Health Initiative still is all about spreading quality.

"Good News: How Hospitals Heal Themselves" is schedule to air at 8 p.m. Thursday on WQED-TV.