Hand Hygiene Program: Engaging Physicians

Transcription

1 Hand Hygiene Program: Engaging Physicians Mary Vearncombe, MD, FRCPC Medical Director, Infection Prevention & Control Sunnybrook Health Sciences Centre

2 Sunnybrook Health Sciences Centre 1200 bed tertiary care hospital, fully affiliated with University of Toronto, on 3 sites Regional programs in trauma, burns, cardiac, oncology, high risk pregnancy and neonatal intensive care, Veteran s Centre

3 HH Compliance (%) SHSC was early adopter of JCYH Steady improvement in compliance since 2007 from < 40% to 90% Hand Hygiene Trend 100% 90% 80% 70% 60% 62% 68% 69% 72% 76% 82% 79% 81% 86% 86% 84% 86% 91% 90% 88% 50% 40% 43% 30% 20% 10% 0% Nov 07- Feb 08 Aug-Oct 08 Nov 08 - Mar 09 Q Q Q Q Q Q Q Q Q Q Q Q Q

4 JCYH and Physician Hand Hygiene Engagement of senior leaders: Barry McLellan, MD, FRCPC President & CEO has made improved hand hygiene a personal corporate goal: Priority 1 in annual QIP

5 JCYH and Physician Hand Hygiene Premise: physicians are role models for other health care providers; physicians are the poorest compliers with hand hygiene; if physician hand hygiene improves, it will facilitate corporate hand hygiene compliance Physician champions: Recruited from each medical department 1 st meeting January 2011; quarterly meetings to identify/discuss issues In-depth education provided on the JCYH program Role models and promotion of hand hygiene Identify specific practice/program based needs: barriers/enablers, education, auditing walk-throughs of their areas Quarterly reports to MAC

6 Physician Champion Role Description Responsible for: Being a role model and mentor Understanding specific practices in your department, enablers and barriers to compliance Being the identified physician hand hygiene leader in your department Being involved in hand hygiene QI projects Identifying unique educational needs for your department Engaging in hand hygiene CME Accountable to Physician Champion Working Group

7 HH Compliance (%) 100 Hand Hygiene Trend by Profession Nursing Staff Medical Staff Allied Health Workers Suport Staff SB Average Nov 07- Feb 08 Aug - Oct 08 Nov 08- Mar 09 Q Q Q Q Q Q Q Q Q Q Q Q Q

8 HH Compliance (%) 100% 90% 80% 89% Hand Hygiene by Profession Q % 89% 88% 83% 70% 60% 50% 40% 30% 20% 10% 0% Nursing Staff Medical Staff Allied Health Staff Support Staff SB Average

9 9 Sunnybrook Physician Champions

10 Physician Champion Buttons Recognition for high performing Staff Physicians Promote conversation 10

11 Physician Champions want data Quarterly hand hygiene compliance data specific to their program/area provided trend for program; current data by ward, profession, moment, staff vs resident/fellow vs medical student Hand hygiene observers target physicians, e.g., ward rounds, to get sufficient physician specific data Some physician champions spent time with observers ; validate data collection Data broken down by staff physician, resident/fellow, medical student target education

12 HH Compliance (%) 100% Hand Hygiene Trend in Medical Group 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Staff Physician Fellow/Resident Medical Student Medical Staff SB Average Q Q Q Q Q Q Q Q Q Q Q Q

13 Resident engagement initiatives Case studies for resident teaching Sunnybrook patients with infection after identified transmission event Medicine; surgery Delivered by attending physicians Other resident engagement initiatives E-learning module Education blog posts Videos using Sunnybrook physicians and residents

14 HH Compliance (%) 100% 90% 80% Hand Hygiene breakdown in Medical Staff Group 85% 86% 83% 80% 88% 70% 60% 50% 40% 30% 20% 10% 0% Staff Physician Fellow/Resident Medical Student Medical Staff Group SB Average

15 Physician Champions want data Use of Sunnybrook specific data Hand hygiene compliance vs MRSA rates Norovirus outbreak: attack rate vs hand hygiene compliance

16 MRSA incidence (per 1000 patient days) Hand Hygiene Compliance (%) Quarter MRSA Hand hygiene Linear (MRSA) Linear (Hand hygiene)

17 Hand Hygiene vs # cases # sick HH Compliance (%) LDMH LGSE LGSW LFSE LFSW LSSE LSSW LTSE LTSW Unit

18 Caught Clean Handed Stickers Given out by hand hygiene observers with feedback tool to recognize high performing staff on hand hygiene compliance 18

19 Corporate Messaging Buttons Given to local opinion leaders Promote awareness and recognition Branding 19