scholarly journals A Statistically Significant Reduction in Hospital Onset Clostridioides difficile Events Using a Learning Collaborative Model

2020 ◽  
Vol 41 (S1) ◽  
pp. s105-s107
Author(s):  
Tracy Louis ◽  
Sandi Hyde
Keyword(s):  
Healthcare System ◽  
Evidence Based ◽  
Learning Collaborative ◽  
Collaborative Model ◽  
Hospital System ◽  
Evidence Based Practices ◽  
Clostridioides Difficile ◽  
Before And After ◽  
Standardize Laboratory ◽  
Us Census

Background: Evidence-based best practices are available for the reduction and prevention of Clostridioides difficile infection (CDI). Often, these practices are not consistently followed in many inpatient care settings. A learning collaborative model resulted in a cost neutral, rapid, sustainable, statistically significant reduction in CDI events across an 88-hospital campus system without requiring hospitals to standardize laboratory methods, increase spending or increase staffing. Methods: In March 2018, a healthcare system with 88 critical access and community hospital campuses across 29 states participated in a harms-reduction learning collaborative. The collaborative format included educational webinars, gap analyses, action plans, and coaching calls facilitated by subject matter experts (SMEs). A collaborative cohort of 11 hospitals (55% rural*) was identified as having significant opportunity for improvement. These facilities participated in 3 monthly coaching calls. The coaching calls supported peer-to-peer sharing of practices and discussions of challenges and successes, and educational materials and presentations were provided by SMEs in pharmacy and infection prevention. Results: Statistically significant changes for the 88-hospital system as a whole: (1) 2018 compared to 2017: P < .001 (statistically significant); (2) 1H2018 compared to 2H2018 (before-and-after collaborative): P = .001; (3) 2019 compared to 2018: P < .001 (statistically significant). Statistically significant changes for the collaborative cohort: (1) 2018 compared to 2017: P < .001; (2) 1H2018 compared to 2H2018 (before-and-after collaborative): P = .002; and (3) 2019 compared to 2018: P < .001. We used 2-proportion, 2-tailed z-test for our analysis. Conclusions: Utilizing a learning collaborative model that included webinars, gap analyses, and interactive coaching calls, a cohort of 11 hospitals was able to induce rapid improvements to adherence of evidence-based practices resulting in a rapid, sustained, statistically significant improvement for both the cohort hospitals and the healthcare system.*2018 American community survey, US Census.Funding: NoneDisclosures: None

scholarly journals Implementation of the Targeted Assessment for Prevention Strategy in a healthcare system to reduce Clostridioides difficile infection rates

2020 ◽  
Vol 41 (3) ◽  
pp. 295-301
Author(s):  
Katelyn A. White ◽  
Minn M. Soe ◽  
Amy Osborn ◽  
Christie Walling ◽  
Lucy V. Fike ◽  
...  
Keyword(s):  
Healthcare System ◽  
Negative Binomial ◽  
Interrupted Time Series ◽  
Strategy Implementation ◽  
System Level ◽  
National Goal ◽  
Clostridioides Difficile ◽  
National Priority ◽  
Before And After ◽  
Prevention Interventions

AbstractBackground:Prevention of Clostridioides difficile infection (CDI) is a national priority and may be facilitated by deployment of the Targeted Assessment for Prevention (TAP) Strategy, a quality improvement framework providing a focused approach to infection prevention. This article describes the process and outcomes of TAP Strategy implementation for CDI prevention in a healthcare system.Methods:Hospital A was identified based on CDI surveillance data indicating an excess burden of infections above the national goal; hospitals B and C participated as part of systemwide deployment. TAP facility assessments were administered to staff to identify infection control gaps and inform CDI prevention interventions. Retrospective analysis was performed using negative-binomial, interrupted time series (ITS) regression to assess overall effect of targeted CDI prevention efforts. Analysis included hospital-onset, laboratory-identified C. difficile event data for 18 months before and after implementation of the TAP facility assessments.Results:The systemwide monthly CDI rate significantly decreased at the intervention (β2, −44%; P = .017), and the postintervention CDI rate trend showed a sustained decrease (β1 + β3; −12% per month; P = .008). At an individual hospital level, the CDI rate trend significantly decreased in the postintervention period at hospital A only (β1 + β3, −26% per month; P = .003).Conclusions:This project demonstrates TAP Strategy implementation in a healthcare system, yielding significant decrease in the laboratory-identified C. difficile rate trend in the postintervention period at the system level and in hospital A. This project highlights the potential benefit of directing prevention efforts to facilities with the highest burden of excess infections to more efficiently reduce CDI rates.

Disseminating, Teaching, and Implementing Evidence-Based Practices

2016 ◽  
pp. 247-266
Author(s):  
John C. Norcross ◽  
Thomas P. Hogan ◽  
Gerald P. Koocher ◽  
Lauren A. Maggio
Keyword(s):  
Implementation Science ◽  
Empirical Research ◽  
Healthcare System ◽  
Research Evidence ◽  
Evidence Based ◽  
Clinical Expertise ◽  
Evidence Based Practices ◽  
What Works ◽  
System P

Moving research evidence from science to service, from the lab bench to the bedside, poses a challenge for evidence-based practices (EBPs). Translation(al) research inclusively refers to the process of successfully moving research-supported discoveries into established practice and policy. This chapter begins with synopses of the empirical research on predicting adoption of EBP and the barriers to its implementation. The chapter then reviews effective methods for disseminating, teaching, and implementing EBPs. Like EBP itself, the new field of implementation science sensitively integrates the best research evidence, clinical expertise, and staff characteristics and preferences into deciding what works in each unique healthcare system.

Development and Application of the NCCTS Learning Collaborative Model for the Implementation of Evidence-Based Child Trauma Treatment

2015 ◽  
Author(s):  
Lori Ebert ◽  
Lisa Amaya-Jackson ◽  
Jan Markiewicz ◽  
John A. Fairbank
Keyword(s):  
Traumatic Stress ◽  
Academic Community ◽  
Evidence Based ◽  
Community Collaboration ◽  
Learning Collaborative ◽  
Collaborative Model ◽  
Traumatized Children ◽  
Effective Care ◽  
Improve Access ◽  
Child Traumatic Stress

Chapter 6 describes a comprehensive model for implementing evidence-based psychological interventions (EBPIs) for child traumatic stress. The Learning Collaborative Model was developed through efforts of the National Child Traumatic Stress Network - a national academic-community collaboration funded by the Substance Abuse and Mental Health Services Administration - that has been implemented widely to improve access to effective care among traumatized children.

scholarly journals Sustainment of Trauma-Focused and Evidence-Based Practices Following Learning Collaborative Implementation

2020 ◽  
Vol 47 (4) ◽  
pp. 569-580 ◽  
Author(s):  
Sarah A. Helseth ◽  
Samuel O. Peer ◽  
Funlola Are ◽  
Alyssa M. Korell ◽  
Benjamin E. Saunders ◽  
...  
Keyword(s):  
Evidence Based ◽  
Learning Collaborative ◽  
Evidence Based Practices ◽  
Collaborative Implementation

A COMPARATIVE STUDY OF EVIDENCE BASED PRACTICES BEFORE AND AFTER INTERNATIONAL ACCREDITATION AND PERCEPTION OF EMPLOYEES

2021 ◽  
pp. 66-68
Author(s):  
Binu Thomas ◽  
Ankur Joshi
Keyword(s):  
Sampling Technique ◽  
Positive Association ◽  
Health Centers ◽  
Evidence Based ◽  
Cross Sectional ◽  
Evidence Based Practices ◽  
Validated Questionnaire ◽  
Before And After ◽  
The Impact

Purpose: To compare the availability of evidence based practices before and after joint commission international accreditation as well as to assess employee perception about the impact of accreditation. Method: Conducted a cross sectional study in 11 health centers belong to Dubai health authority. Prepared a checklist and questionnaire to assess the processes improvements as well as the perception of employees respectively. Studied perception by recruiting physician (n=106) and nurses (n=194) using convenience sampling technique. Done content validity of the tools with clinical quality experts. Conducted pilot study for the questionnaire and checked the reliability using Cronbach alpha (0.924). After obtaining ethical clearance and consent from subjects, the researcher personally visited the health centers and administered validated questionnaire to the participants. To study processes improvements , the researcher audited documents for availability of evidence based practices before and after accreditation using the validated checklist with 17 processes reecting various domains of quality in healthcare . Results: Observed tremendous improvement in the availability of evidence-based practices. The proportion of practices before and after the accreditation was statistically signicantly different (p <.001). Majority (96.3%) of doctors and nurses perceived improvements in practices after accreditation. Statistical signicance was noted between qualication and perception of employees about the impact of accreditation (p <.001). Similarly there was also positive association between length of service and perception (p <.001) Discussion: Observed processes improvements ensuring quality of health care after accreditation. Likewise, majority of employees perceived that the accreditation has improved quality of patient care

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