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Massachusetts CDI Prevention Collaborative Where we are and how we got there. Susanne Salem-Schatz, Sc.D Massachusetts Coalition for the Prevention of Medical Errors November 15, 2011. Objectives for the day (S. Salem-Schatz).
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Massachusetts CDI Prevention CollaborativeWhere we are and how we got there Susanne Salem-Schatz, Sc.D Massachusetts Coalition for the Prevention of Medical Errors November 15, 2011
Objectives for the day (S. Salem-Schatz) • Learn new strategies for C. difficile prevention including screening and testing recommendations • Review the components of the model for improvement • Convey the value of using small tests of change as an implementation strategy • Share the recommended measurement practices for the collaborative • Understand the difference between guidelines and changes to support implementation
The Model for Improvement What are we trying to accomplish? How will we know that a change is an improvement? What changes can we make that will result in improvement? Act Plan Study Do Setting Aims Establishing Measures Selecting Changes W. EdwardsDeming *2001 Associates in Process Improvement
For the Collaborative Reduce the rate of health care –acquired C. difficile infection per 10,000 /patient days by December, 2011 by 30% HA-CDI RATES / 10,000 Patient Days Act Plan Study Do Aim What, By When, How much, for whom Measures What can we try that might help us improvement? CHANGES *2001 Associates in Process Improvement
AIM MEASURES Training in QI, Engagement and Innovation. Create opportunities for shared learning 3 Statewide Learning Sessions 1 set of Regional Workshops Conference Calls Data tracking system Act Plan Study Do For the Collaborative Changes What can we try that might lead to improvement *2001 Associates in Process Improvement
100 percent of CDI patients will be on appropriate precautions (hand hygiene, gloves, gowns, etc) • % of CDI patient rooms with precaution signage • % of staff donning gowns and gloves before entering • % of staff washing with soap and water Act Plan Study Do Example for a Hospital Team Aim Measures • Engage staff in the improvement process • Understand barriers to good practice and come up with ideas for change • Share results with staff on units Changes *2001 Associates in Process Improvement
Act Plan Study Do PDSA: Small Tests of Change Plan: 1 small change to test Predict what will happen Decide on what data to evaluate test Do: Run the test Document problems and observations Organize your data Study Analyze your data Compare results t your predictions Summarize what you have learned Act Decide what to do next More testing? Try something else? Ready to finalize the change?
Some Tips for Testing • Small tests of change • Rule of 1 • 1 patient, 1 staff person, 1 day • Test over short period of time • If they say weeks, think days • If they say days, think hours • PDSA Worksheet to plan your tests