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Core Project Team. HRETMHA Keystone Deborah Bohr, PISam Watson, Co-PI Kevin Van Dyke Christine George, RN John Combes, MD Morgan Martin Kimberly Sepulvado, RN . Study Objectives. Evid
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2. Core Project Team HRET MHA Keystone
Deborah Bohr, PI Sam Watson, Co-PI
Kevin Van Dyke Christine George, RN
John Combes, MD Morgan Martin
Kimberly Sepulvado, RN
3. Study Objectives Evidence-based Practice: How did clinicians and hospital staff learn about evidence-based practice to prevent and mitigate HAI’s?
Adaptive Work and the Comprehensive Unit-based Safety Program: How did teams get started with the adaptive work and what barriers were encountered?
Critical Success Factors: What were the critical success factors in getting started?
Future Research Needs: What types of AHRQ research are recommended? 3
4. Study Methods HAI Information Collection and Reporting Summary: completed by the infection prevention lead at each hospital
Patient Safety and Infection Prevention Catalogue: completed by the patient safety/quality improvement officers of each hospital
Patient Safety and Infection Prevention Assessment: clinicians and other staff
Semi-structured interviews with ICU coordinators at each facility
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5. Assessment Findings 5
6. 6 Context: The Michigan Experience History
Results
“Perfect is Possible”
AHRQ and JHU collaboration
7. Comprehensive Unit-Based Safety Program (CUSP) AHRQ-funded JHU-MHA Keystone success
CUSP elements:
Educate staff on the Science of Safety
Identify defects in care
Commit executive leadership to patient safety at the unit level
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9. 9 What Each Hospital Has in Common
Experience in the Keystone ICU Collaborative since 2004
Evidence-based practice specific to the HAI
Comprehensive Unit-Based Safety Program
10. 10 Barriers and Challenges
Resistance from front-line staff
Naďveté about resource requirements
Unrealistic data collection plans
Lack of staff support for multidisciplinary rounds
Time needed for practice change to take hold
11. 11 Key Lessons
Provide staff with strong evidence base
Communicate expectations and require accountability
Provide strong administrative support
Do what works locally
Use multiple venues to raise awareness and reinforce practice
Observe staff on rounds and provide regular real-time feedback
12. 12 Key Lessons (Cont…)
Provide performance data at least quarterly and post in unit
Establish Nurse Protocols
CUSP critical to success
Start small, then expand
Use arsenal of QI tools; change management, systems, small cycle change, in addition to CUSP tools
MD and RN champions essential
13. 13 Next Steps
Major need for implementation research
Best practices for implementing latest evidence-based practice
Dedicated time for clinicians
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