​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​Program Overview

Initiative Purpose
​ Participants
Partners
Methods For Improvement 
Project Teams
Goals
Activities
Data
The Wins​

Initiative Purpose

Under the joint sponsorship of the California Department of Health Care Services, Children’s Medical Services (CMS) Branch and the California Children’s Hospital Association (CCHA), the purpose of this Initiative is to reduce/eliminate catheter associated blood stream infections (CABSIs) and other hospital acquired infections in California Children’s Services (CCS) approved Regional NICUs.

Participants

The Initiative participants are neonatologists, nurses, infection control personnel, and administrators from the 22 hospitals with CCS-approved Regional NICUs. There are generally three to six participants from each NICU who make up each hospital’s Project Team. Participants in year one included the eight California Children’s Hospitals, four of the five University of California Medical Centers, and Sutter Memorial Medical Center (Sacramento).

Partners

The Initiative partners include:

• Top level leadership at the hospitals, and
• California Perinatal Quality Care Collaborative (CPQCC) for assistance with outcome measures and to build upon their significant efforts in the area of reducing neonatal nosocomial infections (www.cpqcc.org).

Methods for Improvement

The Initiative utilizes three performance improvement modalities:

• The Institute for Healthcare Improvement (IHI) Breakthrough Series (BTS) model (www.ihi.org) focusing on developing leadership commitment;
• The motivational, learning and care process incorporated into the CPQCC Toolkit for Prevention of Hospital-Acquired Infection (www.cpqcc.org); and
• The Microsystem Assessment (organizational assessment, pre- and post-intervention) for enhancing unit performance (www.dms.dartmouth.edu/cms).

Project Teams

• Examine their practices and share their observations regarding relevant activities; and
• Assess their individual needs, establish priorities, and work to achieve their own individual agenda

Goals

• Reduce/eliminate neonatal catheter associated blood stream infections
• Reduce/eliminate other neonatal hospital-acquired infections
• Sustain gains month to month and year to year

Activities​

• Implement the agreed-upon change package
• Perform investigational analysis of the cause of each infection
• Share lessons learned (what worked, what didn’t work) via learning sessions with regular conference calls (every other week) and biannual face-to-face collaborative meetings 
•  Exchange ideas for resolving technical problems

Data

•  All sites reach consensus on data definitions and collection procedures
• Outcomes and observational process data are tracked from baseline through the course of the Initiative, per year
• Each site performs a detailed analysis of the processes used to implement and maintain evidence-based best practices
• Each site does an investigational analysis of the cause of each infection
• Results from individual sites are confidential and any reporting of data is done in aggregate form, to demonstrate overall improvement.

The Wins

• Reduction of hospital acquired infections
• Reduction in patient harm
• Cost-savings for hospitals
• Improved communication among hospital staff
• Best practices shared with other NICUs​