Becker's Clinical Quality & Infection Control

15 Executive Briefing • Education. The practices were communicated to staff in multiple ways including through materials, signage, reminders and huddles. "The key piece was education," Ms. Grimm said, such as "just explaining how it [the CHG foam] should be utilized on every patient every day." There was also staff reeducation on the central line dressing change process. • Sharing data. At some facilities, only the managers see data on infection rates, but Cornerstone decided to share its data with the entire staff. "We communicate with the staff and keep the HAI data at the forefront; every day and every month we discuss our results," Ms. Grimm said. • Staff incentives. Staff received rewards for achieving certain HAI goals. These rewards included group lunches, sweets or clothing. While reducing HAIs is a serious topic, having incentives engaged the staff and kept the process fun. • Monitoring and auditing. Cornerstone engaged in continuous audits. "Staff tend to do what you inspect, not what you expect," Ms. Farmer said. With that in mind, constant inspection is essential. One form of inspection involved unexpected peer-to-peer audits where one staff member observes and audits a peer, with no prior notice. "The staff would audit their peers," Ms. Farmer said. "After the audit is completed, we all return to the nurse's station and we review the results. It was a good way to keep the staff accountable." The changes at Cornerstone also included educating patients, who at times can resist change. It was important to convey to patients the importance of safety and cleanliness to prevent infections. Achieving outstanding results This combination of efforts has paid off. In 2020, Cornerstone Little Rock's CAUTI rate was 0.78 against a target of 2.0 and the CLABSI rate was 0.25 against a target of 1.0. On both of these important measures, Cornerstone is now outperforming national benchmarks. "We have pretty much sustained what we're doing . . . and so far, we're doing pretty good this year [2021]," Ms. Grimm said. Coping with COVID-19 Cornerstone's focus on HAIs during 2020 coincided with heightened attention on safety and cleanliness due to COVID-19. "COVID just raised the awareness with staff," Ms. Grimm said. "It made them extra careful when taking care of patients." She believes that implementing the Model for Enhancement, Advancement and Improvement during this period proved to be good timing because the staff was so focused. Also, implementing this model during COVID showed staff anything is possible. "We can always say to our staff, 'Look, if we did this in the midst of a pandemic, we can do anything,'" Ms. Grimm said. She added, "We did not sit back and use COVID as an excuse. This allowed us to keep our patients safe and keep infections down." Conclusion Cornerstone Specialty Hospitals Little Rock shows it is possible to make and sustain significant changes to practices and processes, leading to dramatic improvement in HAI results. The keys are determining consistent practices and engaging the entire staff in the change process through education, communication, incentives and monitoring. Ms. Grimm offered advice to other acute care hospitals that may be facing infection challenges, summarizing, "The leadership team has to get the bedside staff involved. I think our biggest accomplishment is having the bedside staff engaged. We have had team meetings on their days off, we provided lunch, they came and sat down and we discussed what they were doing at the bedside. The bedside staff has to be involved. They have to know the results, at least monthly, to make a change." Ms. Farmer noted that in 2019, the Little Rock facility "was in the hot seat" during Cornerstone's monthly and quarterly corporate meetings. But now that the Little Rock team is meeting its targets, "We're the star child." These results exhibit what is possible at any facility that has strong leadership, clear focus, consistent practices and specific measures, along with education, team work and monitoring. n We're "Mon • lik • a." We focus on helping care teams deliver their absolute best for patients. More specifically, we address some of the most persistent and stressful issues associated with routine care delivery. Pressure injuries, hospital-acquired infections, clinician injuries — all have devastating and very costly impacts on human lives and health systems. The right medical solutions can make all the difference. From our Biogel® surgical gloves, Mepilex® dressings and Hibiclens® patient bathing solutions to our smartly designed turning and positioning devices, Mölnlycke products simply work better. They're more comfortable for the patient and often more efficient in terms of utilization. The more you know about Mölnlycke, the more our difference becomes clear.

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