Reducing preventable harm: Observations on minimizing bloodstream infections

Research output: Contribution to journalArticle

Abstract

Purpose - The purpose of this paper is to provide a practical framework that health care organizations could use to decrease preventable healthcare-acquired harms. Design/methodology/approach - An existing theory of how hospitals succeeded in reducing rates of central line-associated bloodstream infections was refined, drawing from the literature and experiences in facilitating improvement efforts in thousands of hospitals in and outside the USA. Findings - The following common interventions were implemented by hospitals able to reduce and sustain low infection rates. Hospital and intensive care unit (ICU) leaders demonstrated and vocalized their commitment to the goal of zero preventable harm. Also, leaders created an enabling infrastructure in the way of a coordinating team to support the improvement work to prevent infections. The team of hospital quality improvement and infection prevention staff provided project management, analytics, improvement science support, and expertise on evidence-based infection prevention practices. A third intervention assembled Comprehensive Unit-based Safety Program teams in ICUs to foster local ownership of the improvement work. The coordinating team also linked unit-based safety teams in and across hospital organizations to form clinical communities to share information and disseminate effective solutions. Practical implications - This framework is a feasible approach to drive local efforts to reduce bloodstream infections and other preventable healthcare-acquired harms. Originality/value - Implementing this framework could decrease the significant morbidity, mortality, and costs associated with preventable harms.

Original languageEnglish (US)
Pages (from-to)2-9
Number of pages8
JournalJournal of Health, Organisation and Management
Volume31
Issue number1
DOIs
StatePublished - 2017

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Infection
Delivery of Health Care
Organizations
Safety
Ownership
Quality Improvement
Intensive Care Units
Morbidity
Costs and Cost Analysis
Mortality
Healthcare

Keywords

  • Bloodstream infections
  • Improvement science
  • Patient safety
  • Preventable harm
  • Quality improvement

ASJC Scopus subject areas

  • Health Policy

Cite this

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abstract = "Purpose - The purpose of this paper is to provide a practical framework that health care organizations could use to decrease preventable healthcare-acquired harms. Design/methodology/approach - An existing theory of how hospitals succeeded in reducing rates of central line-associated bloodstream infections was refined, drawing from the literature and experiences in facilitating improvement efforts in thousands of hospitals in and outside the USA. Findings - The following common interventions were implemented by hospitals able to reduce and sustain low infection rates. Hospital and intensive care unit (ICU) leaders demonstrated and vocalized their commitment to the goal of zero preventable harm. Also, leaders created an enabling infrastructure in the way of a coordinating team to support the improvement work to prevent infections. The team of hospital quality improvement and infection prevention staff provided project management, analytics, improvement science support, and expertise on evidence-based infection prevention practices. A third intervention assembled Comprehensive Unit-based Safety Program teams in ICUs to foster local ownership of the improvement work. The coordinating team also linked unit-based safety teams in and across hospital organizations to form clinical communities to share information and disseminate effective solutions. Practical implications - This framework is a feasible approach to drive local efforts to reduce bloodstream infections and other preventable healthcare-acquired harms. Originality/value - Implementing this framework could decrease the significant morbidity, mortality, and costs associated with preventable harms.",
keywords = "Bloodstream infections, Improvement science, Patient safety, Preventable harm, Quality improvement",
author = "Pronovost, {Peter J.} and Sallie Weaver and Sean Berenholtz and Lisa Lubomski and Lisa Maragakis and Marsteller, {Jill A} and Pham, {Julius Cuong} and Sawyer, {Melinda D.} and David Thompson and Kristina Weeks and Michael Rosen",
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AU - Marsteller, Jill A

AU - Pham, Julius Cuong

AU - Sawyer, Melinda D.

AU - Thompson, David

AU - Weeks, Kristina

AU - Rosen, Michael

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AB - Purpose - The purpose of this paper is to provide a practical framework that health care organizations could use to decrease preventable healthcare-acquired harms. Design/methodology/approach - An existing theory of how hospitals succeeded in reducing rates of central line-associated bloodstream infections was refined, drawing from the literature and experiences in facilitating improvement efforts in thousands of hospitals in and outside the USA. Findings - The following common interventions were implemented by hospitals able to reduce and sustain low infection rates. Hospital and intensive care unit (ICU) leaders demonstrated and vocalized their commitment to the goal of zero preventable harm. Also, leaders created an enabling infrastructure in the way of a coordinating team to support the improvement work to prevent infections. The team of hospital quality improvement and infection prevention staff provided project management, analytics, improvement science support, and expertise on evidence-based infection prevention practices. A third intervention assembled Comprehensive Unit-based Safety Program teams in ICUs to foster local ownership of the improvement work. The coordinating team also linked unit-based safety teams in and across hospital organizations to form clinical communities to share information and disseminate effective solutions. Practical implications - This framework is a feasible approach to drive local efforts to reduce bloodstream infections and other preventable healthcare-acquired harms. Originality/value - Implementing this framework could decrease the significant morbidity, mortality, and costs associated with preventable harms.

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