Improving Hand Hygiene: A Systems Approach

April 10, 2008

ExhibitorCubist Pharmaceuticals

Massachusetts Department of Public Health

Betsy Lehman Center for Patient Safety and Medical Error Reduction

Hospital Infection Prevention Collaborative

Support for Reducing Hospital-Acquired Infections

History and Background:Hospital Infection Prevention Collaborative

Lehman Center - State expert panel recommended best practices and infection reporting requirements

JSI working with DPH on Infection Reporting; July 2008 NHSN Oct 2009 Public Reporting

Coalition & MHA Improvement Collaborative DPH helping to fund

Like previous collaboratives – tools, implementation strategies, and learning from colleagues

MRSA, CLABSI, VAP, SSI How low can you go ?

Coalition Activities: Infection Prevention Collaborative

Program Director – Susanne Salem-Schatz Sc.D. Engaging Leadership

MHA/Coalition invitation– 88% signed on Team Leaders from Quality and Infection Control

MHA CEO Regional Briefings – May 1&2 Site visit to Pittsburgh VA – Nov 2007 Education Sessions:

July 2007 – MRSA – 57 hospitals November 2007 – Engaging staff – 54 hospitals April 10, 2008 – Hand Hygiene – 62 hospitals June 25, 2008 – Leadership/Sharing best practices

Coalition Activities: Infection Prevention Collaborative

Conference calls (and audio CDs) Dec 2007 – Engaging front-line staff – 62 participants Jan 2008 – Engaging front-line staff – 92 participants Feb 2008 – Preventing VAP – 121 participants Mar 2008 – Environment cleaning/disinfection – 111 participants

Listserve – 100% hospitals including non-acute– more than 200 people

Mini-collaborative – Engaging front-line 15 hospitals, including non-acute

Website – posting tools and strategies

Infection Prevention Collaborative: Consumer Education Information

Collaborating with participating hospitals IHI Betsy Lehman Center Partnership for Healthcare Excellence

Messages for general public Reduce inappropriate antibiotic use Hand hygiene, cough etiquette MRSA prevention

Education for patients, families, visitors Pre-admission, during hospitalization, post-discharge

Today

Improving Hand Hygiene

Improving Hand Hygiene: the beginning

Ignaz Philipp Semmelweis "savior of mothers" While working at Vienna General Hospital

in Austria, discovered in 1847 that hand washing with chlorinated lime solutions reduced the incidence of fatal puerperal fever from about 10% to about 1-2 %

Improving Hand Hygiene: the beginning

Semmelweis was outraged by the indifference of the medical profession and began writing open and increasingly angry letters to prominent European obstetricians, at times denouncing them as irresponsible murderers

Improving Hand Hygiene: the beginning

Semmelweis was committed to a mental institution in 1865, where he died 14 days later

Better Strategies for Improving Hand Hygiene

Collaborative learning – 180 people Agenda Materials Give us your input on evaluation

Susanne Salem-Schatzsss@hcqi.org

Paula Griswoldpgriswold@macoalition.org

www.macoalition.org781-272-8000 x152

Questions to Guide Your Improvement Planning

Thinking about the big picture: What did you hear that resonates with your own improvement efforts?

Do you have the right people involved in your hand hygiene initiative?

Are you leveraging leadership involvement? What did you learn that might help you better understand your

past successes and challenges? Planning the specifics: What strategies you can test “back home?” Whom should you involve? How will you know if the strategy works?

(Hint – this is about measurement!) What steps will you take?