Beyond the Collaborative: Spreading Effective Improvement in Hand Hygiene Compliance

被引:11
作者
Chassin, Mark R. [1 ]
Nether, Klaus [2 ]
Mayer, Carrie [1 ]
Dickerson, Melody F. [2 ,3 ]
机构
[1] Joint Commiss, Oak Brook Terrace, IL 60181 USA
[2] Joint Commiss Ctr Transforming Healthcare, Oak Brook Terrace, IL USA
[3] Mem Hermann Northwest Hosp, Houston, TX USA
关键词
D O I
10.1016/S1553-7250(15)41003-7
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background: Data assessing the effectiveness of quality improvement (QI) collaboratives are mixed; spreading improvement beyond the original collaborative group has proved difficult. Little is known about whether organizations that did not participate in the collaborative are able to effectively employ interventions developed or implemented by those organizations that did participate. Methods: The Joint Commission Center for Transforming Healthcare conducted a collaborative QI project with eight hospitals, using Lean, Six Sigma, and change management methods to improve hand hygiene compliance. Participating hospitals achieved a 70.5% relative improvement (47.5% to 81.0%; p < .001). Following this project, working with an additional 19 hospitals, the Center created Web-based tools to enable health care organizations to use the same methods employed by the original eight hospitals without needing any knowledge or experience with Lean, Six Sigma, or change management. This Targeted Solutions Tool (R) (TST)(R) allowed organizations to discover the most important, specific causes of hand hygiene noncompliance in their facilities and to target interventions at those causes. Results: In the first three years, 289 health care organizations used the TST to initiate 1,495 projects to improve hand hygiene compliance. Of the 769 projects at 174 organizations for which baseline and improvement data were available, average compliance improved from 57.9% to 83.5% (p < .0001). Similar improvement was observed in many clinical care settings, including ambulatory, long term care, inpatient pediatrics, critical care, and adult medical/surgical units. Conclusion: Hospitals and other health care organizations using the TST achieved levels of hand hygiene compliance comparable to those experienced by the participants in the original collaborative.
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页码:13 / +
页数:16
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