1012 Reduction of hospital acquired conditions through the use of a workstream approach in pilot units in hamad medical corporation

Background Through a system-wide, modified IHI Breakthrough Series Collaborative, staff at the Hamad Medical Corporation aimed to increase the reliability of bundle compliance to reduce hospital acquired infections in critical care units, general wards and for peri-operative patients. Objectives The aim of the collaborative was to achieve 95% reliable use of care bundles and 0 incidence or 300+days between patient harm events in participating units by December 2016. Methods In October 2013, The Best Care Always Collaborative was launched, focusing on improving the reliability of evidence-based care processes and thus improved outcomes for patients. Participating teams apply quality improvement methods to test change packages and aim to implement context-specific care bundles to reduce hospital acquired conditions. All sites submitted qualitative and quantitative data in monthly progress reports. Results Through focused improvement efforts in workstreams the improvement teams were able to reduce instances of hospital acquired infections and in most cases improve process reliability. Please see attached data for detailed analysis. Conclusions The IHI team learned how to work and apply the Science of Improvement in a new cultural context in Doha, Qatar. Reliably applying all elements of evidence-based care bundles can lead to improved outcomes. Healthcare delivery is complex and multiple factors effect patient outcomes. Multi-faceted approaches must be employed to reduce hospital acquired conditions. Further work should be done to develop, test and measure the effects of standard workflows for processes prone to human error and patient harm in this context.