Regional Interventions to Eliminate Healthcare-Associated Infections

Published in: Medical Care, v. 52, no. 2, suppl. 1, Feb. 2014, S46-S53

Posted on RAND.org on February 01, 2014

by Sari Siegel, Katherine L. Kahn

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BACKGROUND: The development of the Health and Human Services (HHS) Action Plan to eliminate healthcare–associated infections (HAIs) and the coordinated efforts of the federal and private sectors to address this patient safety problem present an unprecedented effort to "bend the cost curve" of delivering care through improving quality. Key to this strategy was a multipronged approach at the federal, state, and regional levels. OBJECTIVES: To examine the impact of HHS's Regional Office projects in support of the implementation of the National Action Plan to Eliminate HAIs and to clarify the role played by HHS regions in the multipronged federal effort to combat HAIs. RESEARCH DESIGN: Qualitative; 13 individual semistructured interviews with representatives from 9 regions. Eight interviews were conducted initially and follow-up interviews were conducted 1-year later with original participants. MEASURES: Evaluated results against the modified Context-Input-Process-Product system functions and properties used to evaluate the HAI National Action Plan, including: HAI data and monitoring, knowledge development, infrastructure development, HAI prevention and practice adoption, prioritization, coordination and alignment, accountability and incentives, stakeholder engagement, and resources. RESULTS: Results from the interviews were systematically coded against a framework that documents specific system and properties that characterize the roadmap laid out by the Action Plan. This review assesses progress toward Action Plan goals achieved by these OASH-funded regional projects and finds that these regional activities furthered the National Action Plan goals by addressing the key regional needs. CONCLUSIONS: Key to the success of the National Action Plan was the multilevel approach to implementation of initiatives at the federal, regional, and state levels.

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