A recently published paper on a Department of Veteran’s Affairs (VA) project on CLABSI reduction used the requisite bundles, but focused on education and spreading the word in a manner appropriate to each VA facility (Render, Hasselbeck, Freyberg. BMJ Qual Saf 2011: 20:725-732.) The result was a decline from 3.8 CLABSI infections per 1,000 line days to 1.8 per 1,000 line days.

Marta Render, MD, one of the researchers on the project, said the focus had to be on learning because the VA is a “gargantuan system. We had to think about how to get learning out to people who needed it. We did not want to have to push this out to everyone, but have them pull it in.” To spread the knowledge, they developed web-based tools and kits, including the critical development of the daily goal sheet. “It is a great tool that changed the way we work together,” Render says.

Once implemented and data collection started, Render and the team worked with outliers, conducting structured interviews and setting achievable goals – find a team leader in the next week, check the data the next day. Then the team would follow up on those goals, finding out what went wrong if the goal was not achieved and suggesting potential solutions.

The results were initially rolled out in ICUs, but have since been spread to other inpatient units and VA community living centers. CAUTI and ventilator-associated pneumonia are next on the list.

Source: Hospital Employee Health; November 1, 2011