Teamwork Improving Outcomes in Critical Care

Purpose:
To improve patient outcomes & safety by improving collaboration , communication & teamwork .

Significance:
HAIs double the risk of dying in hospitalized patients and account for about 20,000 deaths yearly in the USA (Hughes 2008 ). Per patient costs for CLABSI is estimated to be $29,156 , VAP $28,508 and for CAUTI $1,007.

Strategy and Implementation:
Interdisciplinary rounds instituted daily by Intensivists collaborating with frontline nursing ,case managers , respiratory therapists to implement IHI Bundles of Care for CLABSI,CAUTI, &VAP & to address all aspects of patient care . Daily data logs kept on the unit & available for all staff coupled with regular communication with Infection control on current innfection rates . Shared governance led a culture change to team ownership of our patient outcomes .

Evaluation:
Improved CLABSI by 29 % in the first year & have had zero rates for thirteen consecutive months. VAP rates decreased decreased by 33 % in the first year & CAUTI reduced by 45 % in 2008 , at zero for 2009 .

Implications for Practice:
Collaboration & communication between frontline staff , physicians , infection control , quality & management in a shared governance environment have made this possible .