Improving Hand Hygiene: A Systems Approach April 10, 2008 Exhibitor Cubist 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-Schatz Paula Griswold 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?