personnel and teams often are unable or unprepared to implement best practices given the idiosyncrasies and complexities of healthcare settings . Identification and application of multifaceted strategies is necessary to ensure progress toward improvement .”
Co-author of the new SHEA / IDSA / APIC practice recommendation , infection prevention consultant Ann Marie Pettis , RN , BSN , CIC , FAPIC , a past-president of APIC , makes an observation about the average hospital ’ s level of success with implementation : “ My sense is that the majority of hospitals struggle with implementation . The term that comes to mind is ‘ fits and starts ,’ as most have engaged in performance improvement initiatives , but sustainability remains elusive , especially post pandemic due to “ lost ground ” in terms of HAI reduction due to staffing issues and financial challenges .”
At its core , Schaffzin says that implementation science “ is the means of identifying the best way to implement something . It involves understanding what needs to be changed , how it needs to be changed , why it is behaving the way it is and why hasn ’ t changed , and then how to effectively affect that change ,” he explains . “ What hospitals really need is that last step , but they also need everything else synthesized to show them how to plug this into current clinical operations . I think the big challenge — both in the field of implementation science and in the hospital setting — is that that transition is not well defined in terms of best practices . There are tons of publications , with very smart people conducting amazing work through taking different
approaches , but it hasn ’ t gotten to a point where it can be synthesized and put into a playbook . We wrote this Compendium recommendations document to help facilities make the transition from theory to action .”
The COVID-19 pandemic hasn ’ t made it any easier for healthcare facilities to engage in implementation , experts acknowledge .
“ Right now , in healthcare in general , I think there ’ s a significant difficulty in recovering from COVID ,” Schaffzin says . “ Just like so many other things , the pandemic has uncovered challenges , including the risk of burnout and the concept of ongoing wellness among healthcare personnel , and people being able to sustain their careers . And the complexity of healthcare continues to grow . I think that hospitals have always faced these challenges , and COVID merely exposed a number of them and introduced maybe a few others . Overall , there ’ s a sense of wanting to continue the work to provide reliable , consistent evidence-based , excellent care to all patients .”
The other challenge is delivering the message for improvement to healthcare personnel appropriately , Schaffzin says . “ Some personnel are going to want to know that it ’ s evidence-based and it absolutely is right . Implementation science is well-grounded in psychological theory and systems theory , and I think that people may not appreciate those nuances . I think that healthcare epidemiologists and infection preventionists are adept at synthesizing information and then feeding it to healthcare personnel to not only help them appreciate how well supported it is , but also how
Coalition for Community & Healthcare Acquired Infection Reduction
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CHAIR is a coalition of members working to build awareness and facilitate the application of engineered infection prevention technologies to reduce Community and Healthcare Acquired Infections .
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