Using Collaboratives to Using Collaboratives to Reduce Central Line- Reduce Central Line- Associated Bloodstream Associated Bloodstream Infections (CLABSI): Infections (CLABSI): A National Implementation A National Implementation Program Program Peter Pronovost, MD John R. Combes, MD
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Using Collaboratives to Reduce Central Line- Associated Bloodstream Infections (CLABSI): A National Implementation Program Peter Pronovost, MD John R.
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Using Collaboratives to Using Collaboratives to Reduce Central Line-Reduce Central Line-
• Reduce adverse drug events from high-hazard medications (e.g., anticoagulants, narcotics, opiates, insulin, sedatives)
• Reduce pressure ulcers
State ConsortiaState Consortia
Project OrganizationProject Organization
• Statewide effort coordinated by State Hospital Association including QIOs and State DOHs
• Collaborative model • Standardized data collection tools and evidence• Local ICU modification of implementing
interventions• Implementing interventions outside the ICU
Participating StatesParticipating States
• 10 states with at least 10 hospitals in 2008-2011California North Carolina
Colorado Ohio
Florida Pennsylvania
Massachusetts Texas
Nebraska Washington
CUSP EXPANSIONCUSP EXPANSION
• All hospitals within the states are eligible
• The following states are in the expansion:Alabama, Alaska, Arizona, Delaware, District of Columbia, Idaho, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Mississippi, Montana, Nevada, North Dakota, Puerto Rico, South Dakota, Utah, Vermont, Virginia, Wyoming
JHU Funded State ProjectsJHU Funded State Projects• Arkansas Hospital Association• Connecticut Hospital
Association• Georgia Hospital Association• Healthcare Association of
Description of Organization Key Contact Name / Title
Key Contact Telephone
Key Contact Email Collaborative Role
Duke Infection Control
Outreach Network (DICON)
https://dicon.mc.duke.edu
DICON is a private membership organization, established in 1997 by Duke physicians and nurses, that exists to advance efforts that improve quality of care and enhance patient safety while minimizing the costs associated with non-evidence based approaches to infection control.
Deverick Anderson, MD, MPH Assistant Professor Medicine
Advisor Role Will support the collaborative effort with infectious disease expertise to provide guidance to the leadership team and collaborative hospitals.
North Carolina
Area Health Education Centers
Program (AHEC)
http://www.med.unc.edu/ahec
NC AHEC’s mission is to meet the state’s health and health workforce needs by providing educational programs in partnership with academic institutions, health care agencies, and other organizations committed to improving the health of the people of North Carolina.
Endorser Role Will support the Collaborative by helping to spread the word and will look at alignment with initiatives.
NC Center for Hospital Quality and
Patient Safety (NC
Quality Center)
http://www.ncqualitycenter.org
Created in 2004, the NC Quality Center, an initiative of the NC Hospital Association, funded by grants and donations, mission is to lead NC hospitals to become the safest and highest quality hospitals in the United States. In addition the NC Quality Center is the federally designated Patient Safety Organization (PSO) for NC.
Barb Edson, RN, MBA, MHA Director of Collaborative Learning
919-677-4121
[email protected] Lead Partner Role Lead role for NC Consortia Liaison between other NC organizations and National group. Liaison between NC hospitals and NC and national consortia.
Florida ConsortiumFlorida ConsortiumOrganization Name
Organization Website
Description of Organization Key Contact Name / Title
Key Contact Telephone
Key Contact Email Collaborative Role* (you may use your own descriptions or use the ones listed below)
Florida Hospital
Association
www.fha.org State hospital association Kim Streit/VP/Health care Research and Information
• Battles JB, Sheridan MM The FLEXTRA Kit: a model for instructor
• support materials. J Biocommunication; 1989:6;3;1-13. 6
CUSP FLEXTRA KitCUSP FLEXTRA Kit• Begins with all existing content as well as new content developed as part of the project• Identifies key concepts to be illustrated through video vignettes• Work with experts in CUSP, care in each selected hospital unit, and adult learning to
develop storyboards and final scripts for the vignettes• The compilation of the video vignettes supervised by clinical experts• The embedding of the video content into DVD and CD format suitable for bundling with
other training materials• The development and editing of the instructional guides, in collaboration with experts in
both CUSP and adult learning concepts• The final bundling of all the resources into print and electronic formats that are:
– Fully in the public domain– 508 compliant– Branded as an AHRQ product, but designed to be co-branded
Emanuel,L (2009)
Core team p repare s State Coordinators to implement CUSP -CLABSI using a
Professional Development Workshop that a. familiarizes them with the project and
the materials; b. teaches them how to teach using these
materials; and c . teaches them how
to facilitate others in implementing
CUSP - CLABSI
State Coordinat or s / core team prepare hospital teams of representatives to implement CUSP -CLABSI using a Train the Trainer
method that a. familiarizes them with the project and
the mater ials; b. teaches them how to teach using these
materials; and c. teaches them how to facilitate others in
implementing CUSP - CLABSI
State coordinators team s
Hospital representatives team s
Hospital workers
12
200
20,000
Hospital representatives work with QI staff at their
hospitals to implement CUSP -CLABSI, blanketing all relevant hospital staff in the relevant
training and rolling out CUSP - CLABSI.
State Coordinators / core team provide follow up coaching calls to hospital representatives.
Core team
Conclusion
HAI Elimination CollaborationHAI Elimination CollaborationPolicy Leadership
AHRQ CDC CMS AHA
Field LeadershipJHU MHA HRET NW
Implementation Leadership
SHA DOH QIO
SummarySummary
• National Commitment
• Strong Collaboration– Federal Agencies– Provider Organizations– State Stakeholders
• Local Consortia Sustainability– Unit Based Culturally Driven Improvements