Dmitry Khodyakov1, M Susan Ridgely1, Christina Huang1, Katherine O DeBartolo2, Melony E Sorbero3, Eric C Schneider4. 1. RAND Corporation, Santa Monica, California, USA. 2. Institute for Healthcare Improvement, Cambridge, Massachusetts, USA. 3. RAND Corporation, Pittsburgh, Pennsylvania, USA. 4. RAND Corporation, Boston, Massachusetts, USA Department of Health Policy and Management, Harvard School of Public Health, Boston, MA, USA Division of General Medicine and Primary Care, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Abstract
BACKGROUND: Diffusion and adoption of effective evidence-based clinical practices can be slow, especially if complex changes are required to implement new practices. OBJECTIVE: To examine how hospital adherence to quality improvement (QI) methods and hospital engagement with a large-scale QI campaign could facilitate the adoption of an enhanced prevention bundle designed to reduce surgical site infection (SSI) rates after orthopaedic surgery (hip and knee arthroplasty). METHODS: We conducted telephone interviews with hospital QI leaders from 73 of the 109 hospitals (67% response rate) in five states that participated in Project JOINTS (Joining Organizations IN Tackling SSIs), a QI campaign run by Institute for Healthcare Improvement (IHI). Using QI methods grounded in the IHI Model for Improvement, this campaign encouraged hospitals to implement an enhanced SSI prevention bundle. Hospital QI leaders reported on their hospital's adherence to the Project JOINTS QI methods; their level of engagement with Project JOINTS activities; and adoption of the SSI prevention bundle components. Interview data were analysed quantitatively and qualitatively. RESULTS: Both adherence to the QI methods and hospital engagement were positively associated with complete bundle adoption. Hospital engagement, especially the use of project materials and tools, was also positively associated with the initiation of and improved adherence to individual bundle components. CONCLUSIONS: Our findings suggest that greater adherence to the QI methods and active hospital engagement in a QI campaign facilitate adoption of evidence-based patient safety bundles in orthopaedic practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
BACKGROUND: Diffusion and adoption of effective evidence-based clinical practices can be slow, especially if complex changes are required to implement new practices. OBJECTIVE: To examine how hospital adherence to quality improvement (QI) methods and hospital engagement with a large-scale QI campaign could facilitate the adoption of an enhanced prevention bundle designed to reduce surgical site infection (SSI) rates after orthopaedic surgery (hip and knee arthroplasty). METHODS: We conducted telephone interviews with hospital QI leaders from 73 of the 109 hospitals (67% response rate) in five states that participated in Project JOINTS (Joining Organizations IN Tackling SSIs), a QI campaign run by Institute for Healthcare Improvement (IHI). Using QI methods grounded in the IHI Model for Improvement, this campaign encouraged hospitals to implement an enhanced SSI prevention bundle. Hospital QI leaders reported on their hospital's adherence to the Project JOINTS QI methods; their level of engagement with Project JOINTS activities; and adoption of the SSI prevention bundle components. Interview data were analysed quantitatively and qualitatively. RESULTS: Both adherence to the QI methods and hospital engagement were positively associated with complete bundle adoption. Hospital engagement, especially the use of project materials and tools, was also positively associated with the initiation of and improved adherence to individual bundle components. CONCLUSIONS: Our findings suggest that greater adherence to the QI methods and active hospital engagement in a QI campaign facilitate adoption of evidence-based patient safety bundles in orthopaedic practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Authors: Eric C Schneider; Melony E Sorbero; Ann Haas; M Susan Ridgely; Dmitry Khodyakov; Claude M Setodji; Gareth Parry; Susan S Huang; Deborah S Yokoe; Don Goldmann Journal: Implement Sci Date: 2017-04-17 Impact factor: 7.327
Authors: Timothy J Stephens; Jonathan R Bamber; Ian J Beckingham; Ellie Duncan; Nial F Quiney; John F Abercrombie; Graham Martin Journal: Implement Sci Date: 2019-08-23 Impact factor: 7.327
Authors: Michael S Calderwood; Deborah S Yokoe; Michael V Murphy; Katherine O DeBartolo; Kathy Duncan; Christina Chan; Eric C Schneider; Gareth Parry; Don Goldmann; Susan Huang Journal: BMJ Qual Saf Date: 2018-10-08 Impact factor: 7.418
Authors: Marta Michas; Lesly Deuchar; Richard Leigh; Mohit Bhutani; Brian H Rowe; Michael K Stickland; Maria B Ospina Journal: Implement Sci Commun Date: 2020-08-21