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A Collaborative, Systems-Level Approach to Eliminating Healthcare-Associated MRSA, Central-Line–Associated Bloodstream Infections, Ventilator-Associated Pneumonia, and Respiratory Virus Infections

Henderson, Donna M.; Staiger, Thomas O.; Peterson, Gene N.; Sinanan, Mika N.; Angiulo, Cindy L.; Makarewicz, Vanessa A.; Wild, Lorie M.; Whimbey, Estella E.

The Journal for Healthcare Quality (JHQ): September-October 2012 - Volume 34 - Issue 5 - p 39–47
doi: 10.1111/j.1945-1474.2012.00213.x
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To achieve sustainable reductions in healthcare-associated infections (HAIs), the University of Washington Medical Center (UWMC) deployed a collaborative, systems-level initiative. With the sponsorship of senior leadership, multidisciplinary teams were established to address healthcare-associated methicillin-resistant Staphylococcus aureus (MRSA), central-line–associated bloodstream infections (CLABSI), ventilator-associated pneumonia (VAP), and respiratory virus infections. The goal of the initiative was to eliminate these four HAIs among medical center inpatients by 2012. In the first 24 months of the project, the number of healthcare-associated MRSA cases decreased 58%; CLABSI cases decreased 54%. Staff and provider compliance with infection prevention measures improved and remained strong, for example, 96% compliance with hand hygiene, 98% compliance with the recommended influenza vaccination program, and 100% compliance with the VAP bundle. Achieving these results required an array of coordinated, systems-level interventions. Critical project success factors were believed to include creating organizational alignment by declaring eliminating HAIs as an organizational breakthrough goal, having the organization's executive leadership highly engaged in the project, coordination by an experienced and effective project leader and manager, collaboration by multidisciplinary project teams, and promoting transparency of results across the organization.

For more information on this article, contact Donna M. Henderson atmatkaz@u.washington.edu.

Donna M. Henderson, BSN, MHA, is the Quality Liaison/MD Coach for Medical Services Administration at the University of Washington Medical Center in Seattle, Washington. In her current role, she serves as an internal consultant and project manager for initiatives related to clinical and operational process improvement. During the past 2 years, she has been the project manager for the University of Washington Medical Center's Infection Control Breakthrough Goal Project.

Thomas O. Staiger, MD, is an Associate Professor of Medicine at the University of Washington. He is Medical Director of the University of Washington Medical Center. His academic interests include the diagnostic evaluation of low back pain, the use of antidepressants to treat chronic pain, physician–patient communication, and educating physicians regarding leadership and quality improvement.

Gene N. Peterson, MD, PhD, is an Associate Professor of Anesthesiology and Pain Medicine at the University of Washington. He is the Associate Medical Director of the Center for Clinical Excellence. In this role he works to ensure that all faculty, residents and staff have the tools and information they need to provide high quality care. He has a research interest in use of anesthesia information management systems to improve operating room care and engagement of resident physicians in quality improvement as part of their training.

Mika N. Sinanan, MD, PhD, is a Professor of Surgery at the University of Washington, with a research interest in the objective measurement and analysis of surgical performance, surgical simulation, and robotics. His clinical practice centers around the surgical treatment of gastrointestinal diseases with a special focus on inflammatory bowel disease, cancer of the colon and rectum, and reoperative general surgery.

Cindy L. Angiulo, MSN, BSN, is an Associate Administrator at the University of Washington Medical Center in Seattle, Washington. In her current role she provides leadership for clinical regulatory compliance, in addition to operational oversight for Infection Prevention and Control, Employee Health, Clinical Transfusion Services, Digestive Disease Center and Bronchoscopy Services, and Nursing Recruitment and Retention. During the past 2 years, she provided leadership for the medical center-wide Infection Control Breakthrough Goal Project.

Vanessa A. Makarewicz, RN, MN, is the Medical/Surgical/Vascular Access Clinical Nurse Specialist at the University of Washington Medical Center. Her current focus of work includes standardizing insertion and maintenance practices of central venous catheters to reduce central-line bloodstream infections.

Lorie M. Wild, PhD, RN, NEA, BC, is the Chief Nursing Officer and Senior Associate Administrator at the University of Washington Medical Center. In her current role, she oversees professional nursing practice and patient care operations to ensure quality, safety, and service. Her professional and academic interests surround evidence-based practice, professionalism, and organizational influences on nurses’ clinical practice and patient outcomes.

Estella E. Whimbey, MD, is an Associate Professor of Medicine at the University of Washington. She is the Medical Director of Infection Control and Employee Health at the University of Washington Medical Center. Her primary academic interest is in infection prevention quality improvement initiatives aiming to safeguard the well-being of patients and healthcare workers.

© 2012 National Association for Healthcare Quality
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