Reducing Three Infections Across Cardiac Surgery Programs: A Multisite Cross-Unit Collaboration

Bickey H. Chang, Yea-Jen Hsu, Michael Rosen, Ayse Gurses, Shu Huang, Anping Xie, Kathleen Speck, Jill A Marsteller, David Thompson

Research output: Contribution to journalArticle

Abstract

Using a pre–post design, this study examined the impact of a multifaceted program to simultaneously improve 3 health care–associated infections and patient safety culture throughout the cardiac surgery service line in 11 hospitals. Interventions included the Comprehensive Unit-based Safety Program to improve safety culture and evidence-based bundles to prevent central line–associated bloodstream infection (CLABSI), surgical site infection (SSI), and ventilator-associated pneumonia (VAP). CLABSIs and SSIs showed a downward trend over 2 years, then the rates returned to levels similar to baseline in the third year. VAP rate changes were difficult to interpret because of the VAP definition change. Patient safety culture domain “hospital management support” showed significant improvement, but feedback and communication about errors and staffing declined. Simultaneous implementation of multiple interventions across units is challenging. The findings highlight the importance of sustainment efforts and suggest future work should anticipate both positive and negative change in safety culture dimensions.

Original languageEnglish (US)
JournalAmerican Journal of Medical Quality
DOIs
StatePublished - Jan 1 2019

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Safety Management
Ventilator-Associated Pneumonia
Thoracic Surgery
Patient Safety
Infection
Surgical Wound Infection
Safety
Health

Keywords

  • handoff
  • infection control
  • patient safety
  • safety culture
  • teamwork

ASJC Scopus subject areas

  • Health Policy

Cite this

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abstract = "Using a pre–post design, this study examined the impact of a multifaceted program to simultaneously improve 3 health care–associated infections and patient safety culture throughout the cardiac surgery service line in 11 hospitals. Interventions included the Comprehensive Unit-based Safety Program to improve safety culture and evidence-based bundles to prevent central line–associated bloodstream infection (CLABSI), surgical site infection (SSI), and ventilator-associated pneumonia (VAP). CLABSIs and SSIs showed a downward trend over 2 years, then the rates returned to levels similar to baseline in the third year. VAP rate changes were difficult to interpret because of the VAP definition change. Patient safety culture domain “hospital management support” showed significant improvement, but feedback and communication about errors and staffing declined. Simultaneous implementation of multiple interventions across units is challenging. The findings highlight the importance of sustainment efforts and suggest future work should anticipate both positive and negative change in safety culture dimensions.",
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AU - Rosen, Michael

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AU - Huang, Shu

AU - Xie, Anping

AU - Speck, Kathleen

AU - Marsteller, Jill A

AU - Thompson, David

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