Why strive for merely minor improvement when lives are at stake? Shannon’s pet peeve is benchmarking—the thinking all too common in hospitals today that it’s okay to have infections and medical errors so long as they don’t exceed the national average. “Who volunteers to have a family member get one of the infections we plan on having this year?” The goal has to be zero infections and perfect care,says Shannon, who is Chairman of the Department of Medicine at Allegheny.

How was that goal reached? By ensuring that all caregivers meticulously follow a regimen for inserting and removing central lines that includes masks, gowns, gloves, and drapes; inserting lines in the neck area rather than in the groin area,which is more difficult to keep clean; rearranging supply closets to ensure that the supplies needed to carry out this regimen are easily accessible, even when staff are rushed; and empowering all staff members to enforce hand cleaning and other rules of hygiene. If a doctor doesn’t clean his hands, the nurse working alongside can call a halt to the procedure until the doctor complies.

Shannon oversees some 800 employees and a $150 million budget.Nevertheless, he makes time to speak across the country, with PowerPoint in tow, showing his audiences that preventing infections is possible and profitable. Doing the right thing costs less, he says, using Allegheny’s financial records to prove the point. A typical example is the tragic case of a woman who came into the hospital for stomach reduction surgery, a procedure that should have produced a $9,900 gross profit for the hospital. But when she developed a central line-associated bloodstream infection and had to spend 47 days in the hospital, that profit turned into a $16,000 loss. Preventing CLABs saved Allegheny $1.4 million the first year.

The best news of all is that the success at Allegheny is being duplicated by at least a few other institutions. At Johns Hopkins, catheter-related bloodstream infections in the intensive care unit have been virtually eliminated. How? ICU staff were educated about the seriousness of catheter-related infections; a catheter-insertion cart was created to ensure that necessary equipment was readily at hand; doctors were asked daily whether catheters should be removed; bedside nurses were given a safety checklist to follow during insertion; and nurses were empowered to stop procedures if safety rules were not being followed. Peter Provonost, the intensive care physician at Johns Hopkins who developed the safety checklist, sees the success as proof that infections are not inevitable.