Designing and Evaluating Patient Safety Improvement Programs
Designing and Evaluating Patient Safety Improvement Programs
Quality improvement programs often pose unique project management challenges, including multi-faceted interventions that evolve over time and teams with few resources for data collection. Thus, it is difficult to report methods and results. We developed a program to reduce central line-associated bloodstream infections (CLABSIs) and improve safety culture in intensive care units (ICUs). As previously reported, we worked with 103 Michigan ICUs to implement this program, and they achieved a 66% reduction in the median CLABSI rate and sustained the reduction. This success prompted the spread of this program to Spain, England, Peru and across the USA. We developed a logical framework approach (LFA) to guide project management; to incorporate the cultural, clinical and capacity variations among countries; and to ensure early alignment of the project's design and evaluation. In this paper, we describe the use of the LFA to systematically design, implement and evaluate large-scale, multi-faceted, quality improvement programs.
Guidance to successfully implement and evaluate healthcare quality improvement and patient safety programs is limited. These programs pose unique challenges, including multi-faceted interventions that generally evolve over time and often have few resources for data collection, which makes it difficult to report methods and results. We developed a program to reduce central line-associated bloodstream infections (CLABSI) and improve safety culture (Comprehensive Unit-based Safety Program; 'CUSP') in intensive care units (ICUs). As previously reported, we worked with 103 Michigan ICUs to implement this program, and they achieved a 66% reduction in the median CLABSI rate [3] and sustained the reduction for over 3 years. Moreover, safety climate scores improved by 10%. This success prompted the spread of this CUSP/CLABSI program to Spain, England, Peru and nationwide in the USA.
In these initiatives, we use a logical framework approach (LFA) to guide project management; to incorporate the cultural, clinical and capacity variations among countries; and to ensure early alignment of the project's design and evaluation.
In this paper, we use our ICU CUSP/CLABSI program in Michigan as a case study to describe how project directors can use the LFA to systematically design, implement and evaluate large-scale, multi-faceted, quality improvement programs.
Abstract and Introduction
Abstract
Quality improvement programs often pose unique project management challenges, including multi-faceted interventions that evolve over time and teams with few resources for data collection. Thus, it is difficult to report methods and results. We developed a program to reduce central line-associated bloodstream infections (CLABSIs) and improve safety culture in intensive care units (ICUs). As previously reported, we worked with 103 Michigan ICUs to implement this program, and they achieved a 66% reduction in the median CLABSI rate and sustained the reduction. This success prompted the spread of this program to Spain, England, Peru and across the USA. We developed a logical framework approach (LFA) to guide project management; to incorporate the cultural, clinical and capacity variations among countries; and to ensure early alignment of the project's design and evaluation. In this paper, we describe the use of the LFA to systematically design, implement and evaluate large-scale, multi-faceted, quality improvement programs.
Introduction
Guidance to successfully implement and evaluate healthcare quality improvement and patient safety programs is limited. These programs pose unique challenges, including multi-faceted interventions that generally evolve over time and often have few resources for data collection, which makes it difficult to report methods and results. We developed a program to reduce central line-associated bloodstream infections (CLABSI) and improve safety culture (Comprehensive Unit-based Safety Program; 'CUSP') in intensive care units (ICUs). As previously reported, we worked with 103 Michigan ICUs to implement this program, and they achieved a 66% reduction in the median CLABSI rate [3] and sustained the reduction for over 3 years. Moreover, safety climate scores improved by 10%. This success prompted the spread of this CUSP/CLABSI program to Spain, England, Peru and nationwide in the USA.
In these initiatives, we use a logical framework approach (LFA) to guide project management; to incorporate the cultural, clinical and capacity variations among countries; and to ensure early alignment of the project's design and evaluation.
In this paper, we use our ICU CUSP/CLABSI program in Michigan as a case study to describe how project directors can use the LFA to systematically design, implement and evaluate large-scale, multi-faceted, quality improvement programs.
