Jeanmarie Mayer1, Stacey Slager2, Peter Taber2, Lindsay Visnovsky2, Charlene Weir3. 1. Department of Internal Medicine, University of Utah Health, Salt Lake City, UT; VA Salt Lake City Health Care System, Salt Lake City, UT. Electronic address: jeanmarie.mayer@hsc.utah.edu. 2. Department of Internal Medicine, University of Utah Health, Salt Lake City, UT; VA Salt Lake City Health Care System, Salt Lake City, UT. 3. Department of Internal Medicine, University of Utah Health, Salt Lake City, UT.
Abstract
BACKGROUND: Coordinated approaches are needed to optimally control the spread of resistant organisms across facilities that share patients. Our goal was to understand social tensions that may inhibit public health-led community partnerships and to identify factors for success. METHODS: A collaborative to control transmission of multidrug-resistant organisms (MDROs) was formed in Utah following a regional outbreak, with members from public health, hospitals, laboratories, and transport services. We conducted and qualitatively analyzed 3 focus groups among collaborative stakeholders to discuss their experiences. RESULTS: Via 3 focus groups and additional interviews, we found the collaborative made institutional tensions between stakeholders explicit. We identified 4 factors that facilitated the ability to overcome institutional tensions: public health leadership to establish a safe space, creation of cross-institutional group identity with mutual respect and support, standardized communication, and group cohesiveness through shared mental models of interdependencies. DISCUSSION: Stakeholders' concerns regarding being blamed for MDRO transmission versus contributing to shared health care community MDRO control efforts resembled a "prisoner's dilemma." Four social components mitigated tensions and facilitated cooperation in this public health-led collaborative. CONCLUSIONS: This study identified strategies that public health-led coordinated approaches can use to facilitate cooperation.
BACKGROUND: Coordinated approaches are needed to optimally control the spread of resistant organisms across facilities that share patients. Our goal was to understand social tensions that may inhibit public health-led community partnerships and to identify factors for success. METHODS: A collaborative to control transmission of multidrug-resistant organisms (MDROs) was formed in Utah following a regional outbreak, with members from public health, hospitals, laboratories, and transport services. We conducted and qualitatively analyzed 3 focus groups among collaborative stakeholders to discuss their experiences. RESULTS: Via 3 focus groups and additional interviews, we found the collaborative made institutional tensions between stakeholders explicit. We identified 4 factors that facilitated the ability to overcome institutional tensions: public health leadership to establish a safe space, creation of cross-institutional group identity with mutual respect and support, standardized communication, and group cohesiveness through shared mental models of interdependencies. DISCUSSION: Stakeholders' concerns regarding being blamed for MDRO transmission versus contributing to shared health care community MDRO control efforts resembled a "prisoner's dilemma." Four social components mitigated tensions and facilitated cooperation in this public health-led collaborative. CONCLUSIONS: This study identified strategies that public health-led coordinated approaches can use to facilitate cooperation.
Authors: Peter Taber; Charlene Weir; Jorie M Butler; Christopher J Graber; Makoto M Jones; Karl Madaras-Kelly; Yue Zhang; Ann F Chou; Matthew H Samore; Matthew Bidwell Goetz; Peter A Glassman Journal: Am J Infect Control Date: 2021-01-27 Impact factor: 2.918
Authors: Stefan Bushuven; Markus Dettenkofer; Andreas Dietz; Stefanie Bushuven; Petra Dierenbach; Julia Inthorn; Matthias Beiner; Thorsten Langer Journal: PLoS One Date: 2021-02-22 Impact factor: 3.240