Major article
Introducing the No Preventable Harms campaign: Creating the safest health care system in the world, starting with catheter-associated urinary tract infection prevention

https://doi.org/10.1016/j.ajic.2014.11.016Get rights and content
Under a Creative Commons license
open access

Highlights

  • We describe a regional campaign to reduce hospital-acquired conditions.

  • Catheter-associated urinary tract infection (CAUTI) prevention was the first focus.

  • CAUTI rates significantly declined in nonintensive care units after the initiative.

  • Qualitative evaluation provided several themes for improving regional initiatives.

  • A regional collaborative appears to be a useful strategy for reducing patient harms.

Background

Endemic health care-associated safety problems, including health care-associated infection, account for substantial morbidity and mortality. We outline a regional No Preventable Harms campaign to reduce these safety problems and describe the initial results from the first initiative focusing on catheter-associated urinary tract infection (CAUTI) prevention.

Methods

We formed a think tank composed of multidisciplinary experts from within a 7-hospital Midwestern Veterans Affairs network to identify hospital-acquired conditions that had strong evidence on how to prevent the harm and outcome data that could be easily collected to evaluate improvement efforts. The first initiative of this campaign focused on CAUTI prevention. Quantitative data on CAUTI rates and qualitative data from site visit interviews were used to evaluate the initiative.

Results

Quantitative data showed a significant reduction in CAUTI rates per 1,000 catheter days for nonintensive care units across the region (2.4 preinitiative and 0.8 postinitiative; P = .001), but no improvement in the intensive care unit rate (1.4 preinitiative and 2.1 postinitiative; P = .16). Themes that emerged from our qualitative data highlight the need for considering local context and the importance of communication when developing and implementing regional initiatives.

Conclusions

A regional collaborative can be a valuable strategy for addressing important endemic patient safety problems.

Key Words

Collaborative
Patient safety
Hospital-acquired conditions
Regional medical programs
Hospital unit culture

Cited by (0)

This work was funded by the Department of Veterans Affairs, Veterans in Partnership VISN 11 Healthcare Network, and by the Department of Veterans Affairs National Center for Patient Safety. The findings and conclusions in this report are those of the authors and do not necessarily represent the position or policy of the Department of Veterans Affairs.

Conflicts of interest: None to report.