825 Enlisting University Partners to Address Knowledge Gaps Facing State Healthcare Associated Infection (HAI) Programs

Sunday, March 21, 2010
Grand Hall (Hyatt Regency Atlanta)
Jim Benneyan, PhD , Northeastern University, Boston, MA
Allan Best, PhD , InSource, Vancouver, BC, Canada
David Birnbaum, PhD, MPH , Washington State Dept. of Health, Olympia, WA
Elizabeth Borycki, RN, MN, PhD , University of Victoria School of Health Information Science, Victoria, BC, Canada
Christine A. Goeschel, RN, MPA, MPS , Johns Hopkins University, Baltimore, MD
Bill Jarvis, MD , Jason and Jarvis Associates, Hilton Head, SC
André Kushniruk, PhD , University of Victoria School of Health Information Science, Victoria, BC, Canada
Kathy Mazor, EdD , University of Massachusetts Medical School, Worcester, MA
Peter Pronovost, MD, PhD, FCCM , Johns Hopkins University, Baltimore, MD
Sam Sheps, MD, MSc, FRCPC , University of British Columbia School of Population and Public Health, Vancouver, BC, Canada
Background: For HAI prevention and control, there are well-defined roles, long traditions of involvement and guidance documents for hospitals, healthcare professionals, local & federal public health agencies.  State health departments (SHD), recently drawn into prominence by mandatory HAI reporting legislation, face lack of role definition and guidance documents.
Since 2003, a rapidly growing number of states passed such laws.  SHD responded with new programs to collect and report unfamiliar information.  A legal mandate for more transparency is clear, but important knowledge gaps, unproven assumptions and conflicting expectations underlie mandatory HAI reporting.  It is difficult to know how best to develop these new programs for maximum impact and eventually accurately measure net value.  Health departments typically have neither resources nor a research focus to address these important knowledge gaps.
Objective: (1) Explore potential for collaborative relationships between a SHD HAI Program and university research faculty as evaluation research partners. (2) Identify fundamental questions that need to be answered if HAI Programs are to demonstrate effectiveness or cost-effectiveness.
Methods: Washington’s HAI Program recruited university research faculty to join an interdisciplinary collaborative effort.  In university seminars & other venues, key aspects of historical development, program philosophy and strength of evidence underlying fundamental assumptions were described. A conceptual model was presented, indicating the range of academic disciplines needed to address this topic (shaded area in Figure). Faculty members were recruited to fill the academic disciplines listed; reasons for joining and questions identified by the group were obtained from communications among group members.
Results: Members identified 8 major reasons for joining. The collaborative is thought to help meet challenges academics face in: 1) getting stakeholders to pay attention to results of their research; 2) extending conduct of research into new areas & “real world” settings, evaluating whether findings obtained under controlled conditions persist in real-world settings; 3) finding opportunities for professional growth, and learning from other disciplines. As allied health professionals, academics shared SHD concerns of: 4) building capacity quickly in state agencies to apply sophisticated methods; 5) learning from trends found in patient safety reporting; 6) improved understanding of complex systems change and HAI dynamics (as typical of adverse events); 7) improving information delivery, and 8) finding best ways to make hospitals more resilient “learning organizations” thus confirming universal applicability of optimal organizational development approaches.

Conclusions: This model addresses everyone’s needs. It is a useful, productive approach.