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1 Eliminating MRSA Infections Plexus MRSA Bundle:The HOW of Staff Engagement and Culture Change
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1 Eliminating MRSA Infections Plexus MRSA Bundle:The HOW of Staff Engagement and Culture Change.

Dec 22, 2015

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Page 1: 1 Eliminating MRSA Infections Plexus MRSA Bundle:The HOW of Staff Engagement and Culture Change.

1

Eliminating MRSA Infections

Plexus MRSA Bundle:The HOW of Staff Engagement and Culture Change

Page 2: 1 Eliminating MRSA Infections Plexus MRSA Bundle:The HOW of Staff Engagement and Culture Change.

20,000die every year

in the U.S. from

MRSA infections…

20,000

…more than die from AIDS

Page 3: 1 Eliminating MRSA Infections Plexus MRSA Bundle:The HOW of Staff Engagement and Culture Change.

Public trust is eroding

MRSA Skyrockets in Washington State

Source: Seattle Times analysis; state Department of Health dateAmanda Rymond / The Seattle Times

Cases of hospital patients with MRSA have jumped 33-fold since 1997 in Washington state

33 fold

Page 4: 1 Eliminating MRSA Infections Plexus MRSA Bundle:The HOW of Staff Engagement and Culture Change.

Where do you find

MRSA in Hospitals?Everywhere!

Page 5: 1 Eliminating MRSA Infections Plexus MRSA Bundle:The HOW of Staff Engagement and Culture Change.

MRSA CAN be stopped!

MRSA incidence rates – Billings ClinicHousewide – January 1999 – December 2008

1st Jan, 2005 – 30th June, 2008

84%Reduction in HA MRSA infections

Active surveillance began in ICU Jan 2007

May 2006 PD/MRSA project began

84%

(4 people)

(9 people)

(14 people)

(20 people)

(33 people)

(38 people)

(34 people)

(14 people) (6 people)0.13

June - Dec

Page 6: 1 Eliminating MRSA Infections Plexus MRSA Bundle:The HOW of Staff Engagement and Culture Change.

What’s it going to take to STOP spreading MRSA?

Page 7: 1 Eliminating MRSA Infections Plexus MRSA Bundle:The HOW of Staff Engagement and Culture Change.

Preventing MRSA

infections is primarily a

complex social and

behavioral challenge

rather than a knowledge

or technical problem.

Page 8: 1 Eliminating MRSA Infections Plexus MRSA Bundle:The HOW of Staff Engagement and Culture Change.

All invited and included

Page 9: 1 Eliminating MRSA Infections Plexus MRSA Bundle:The HOW of Staff Engagement and Culture Change.

The Plexus MRSA Bundle helps you to get everyone to do their part

Social and Behavioural Change

Processes

Targeting Tools

Feedback Tools

Monitoring Tools

Learning Collaborative

Coaching for in-house facilitators

Page 10: 1 Eliminating MRSA Infections Plexus MRSA Bundle:The HOW of Staff Engagement and Culture Change.

Engagement, engagement, engagement!

…in an array of proven social change processes, featuring Positive Deviance, designed to engage everyone in:

Discovering which of their practices can play

a role in the transmission of MRSA

Spreading effective practices, creating new

practices and deciding what changes they need to make personally and together

Page 11: 1 Eliminating MRSA Infections Plexus MRSA Bundle:The HOW of Staff Engagement and Culture Change.

Targeting tools

…so that healthcare workers are able to identify which patients are MRSA positive and require contact precautions

This consists of actively

screening patients on

admission and providing

the results to hospital

units immediately

Page 12: 1 Eliminating MRSA Infections Plexus MRSA Bundle:The HOW of Staff Engagement and Culture Change.

Feedback tools

…for healthcare workers to know how many transmissions have taken place on their unit

This consists of screening patients upon transfer or discharge and comparing

the results with admission data, then feeding this

information back to all staff members weekly

Page 13: 1 Eliminating MRSA Infections Plexus MRSA Bundle:The HOW of Staff Engagement and Culture Change.

Monitoring tools

…for the staff to track their OWN performance with essential infection control practices on their unit

Staff may choose to track the percentage of swabbing at

admission, discharge or transfer and conduct periodic surveys on compliance with hand washing and standard

isolation precautions (gloving and gowning)

Page 14: 1 Eliminating MRSA Infections Plexus MRSA Bundle:The HOW of Staff Engagement and Culture Change.

Learning collaborative

Every hospital implementing the Plexus MRSA Practice Change Bundle is connected with other facilities engaged in the same process and others who have already implemented it

Page 15: 1 Eliminating MRSA Infections Plexus MRSA Bundle:The HOW of Staff Engagement and Culture Change.

Coaching for in-house facilitators make the change process sustainable long-term

Page 16: 1 Eliminating MRSA Infections Plexus MRSA Bundle:The HOW of Staff Engagement and Culture Change.

The Plexus MRSA Bundle

6 to 12 months initiative

Bottom-up with top-down support

All invited and included

Self-discovery

Self-monitoring

Sustainable practices

Learning to find solutions

Page 17: 1 Eliminating MRSA Infections Plexus MRSA Bundle:The HOW of Staff Engagement and Culture Change.

Dr. Jon Lloyd, Pittsburg VA

They all pointed at the ICP staff

When we asked the staff:Who is responsible for infection control?

A year later everyone raised his hand

“ ”

Page 18: 1 Eliminating MRSA Infections Plexus MRSA Bundle:The HOW of Staff Engagement and Culture Change.

The Palmer Method

Page 19: 1 Eliminating MRSA Infections Plexus MRSA Bundle:The HOW of Staff Engagement and Culture Change.

Jerry Zuckerman, MD, medical director of infection prevention and control, Albert Einstein Medical Center

I’ve seen more

change at Einstein

in the last six

months than in my

16 year career in

infection control.

Page 20: 1 Eliminating MRSA Infections Plexus MRSA Bundle:The HOW of Staff Engagement and Culture Change.

Results

Healthcare associated MRSA

infection rates for

RWJF/Plexus pilot units from

2006 to 2008 declined

74%

Page 21: 1 Eliminating MRSA Infections Plexus MRSA Bundle:The HOW of Staff Engagement and Culture Change.

Close to Zero

MRSA incidence rates – PD MRSA Intervention Unit - ICUJanuary 2004 – December 2008

2.61(13 people infected)

2.72(14 people infected)

2.76(14 people infected)

0.38(2 people infected)

0.20(1 person infected)

2004 2005 2006 2007 CY 2008Jan-Dec

4

3

2

1

0

Jan 1, 2006 – Jun 30 2008100% reduction in HA

MRSA infections

2006 –200786% decrease

2007 –2008100% decrease

2 others achieved reductions of

65-70%

Page 22: 1 Eliminating MRSA Infections Plexus MRSA Bundle:The HOW of Staff Engagement and Culture Change.

While national rates

of MRSA HAI’s go

up, RWJ/Plexus PD

beta site rates are

going down.

”Dr. John Jernigan, CDC

Page 23: 1 Eliminating MRSA Infections Plexus MRSA Bundle:The HOW of Staff Engagement and Culture Change.

How many $$$$ could you save by reducing MRSA infections?

MRSA infections result in…

Increased lengths of stay

Opportunity costs

Unreimbursed expenses

Potential liability

Page 24: 1 Eliminating MRSA Infections Plexus MRSA Bundle:The HOW of Staff Engagement and Culture Change.

Long term benefits

HospitalReputation

Leadership Development

Break Down Silos

Liability/Risk Reduction

Reduction of MRSA Burden

Process Skills Applicable to Other Issues

Page 25: 1 Eliminating MRSA Infections Plexus MRSA Bundle:The HOW of Staff Engagement and Culture Change.

The work of Plexus Institute initiative using

PD to fight MRSA in hospitals, was one of The

New York Times Magazine featured ideas

of the year for 2008

Page 26: 1 Eliminating MRSA Infections Plexus MRSA Bundle:The HOW of Staff Engagement and Culture Change.

Plexus Institute

Call us:

+1 202.344.5930

Email:

[email protected]

Want tolearn more?