Best Practice for Best Outcomes
WHO: iCareQuality is a best practice firm with healthcare innovation labs in Philadelphia and Toronto. The iCQ team partnered with a community hospital in New Jersey to use the AHRQ CAUTI Toolkit to reduce catheter associated urinary tract infections in the clinical setting. The QI project was implemented using the iCM Mobile platform as part of the hospital yearly improvement plan and conducted over 10 weeks during the Spring of 2016. The purpose of this pilot project was to increase nursing knowledge of AHRQ CAUTI best practices; (2) enhance frontline provider engagement; and (3) measure mobile technology uptake at the point of care in the acute care setting.
CHALLENGE: Although healthcare is embracing mobile information technology with a global reach; yet adoption is slow and challenges remain with implementation and connectivity issues. The NJ hospital was previously part of the CUSP project in 2013, but noted patient complexity, sparse clinical resources, and low provider engagement that inhibited ongoing improvement and sustainability efforts. As with other similar institutions, outcomes were less than ideal and resulted in decreased organization performance and adverse patient outcomes. In recent months, Leapfrog reported medical errors to be the 3rd leading cause of death in the US. Failure to implement best practices, such as the AHRQ Toolkit, in a sustainable, cost effective manner, may contribute to medical errors, clinical inefficiencies, and hospital waste.
RESULTS: CAUTI is one of the most common hospital acquired condition and was the focus of this project in order to positively impact preventable deaths, and improve patient and provider outcomes. The project plan included a multi-modal, time-series educational intervention design, incorporating the iCM Mobile Toolkit with online gamification, machine learning, and targeted staff educational activities. The mobile technology platform by iCareQuality included AHRQ CAUTI modules for shift-to-shift report, best practice CAUTI guide book, case studies, videos, quizzes, discussion board, and gamification reward points. The project setting included ICU and Medical/Surgical nurses. Fifty frontline providers participated in Phase I that was mandatory, and 26 staff continued to participate in Phase II which was voluntary. Data showed a 20% increase in CAUTI staff knowledge pre and posttest p<.02; with a 300% reduction in Foley Free device days compared to 2015. Staff accrued 3800 gamification points for learning activities and were awarded gift cards for participation. Staff rated “User Technology Acceptance” as very favorable in order to access frontline clinical learning tools. LEARNING: Key findings from this socio-technical clinical project were threefold. The project demonstrated that a “just-in-time” education platform, using mobile technology at the point of care, not only improved staff learning but sustained ongoing provider knowledge with respect to CAUTI best practices. Mobile tools helped to enhance clinical workflow efficiency and effectiveness by accessing AHRQ Tools at the point of care. Finally, incentivized learning and gamification principles, when applied tactically in the clinical learning environment, helped to drive “active” workforce engagement. Leveraging mobile technology with targeted staff learning opportunities allowed providers to accrue rewards points, acquire best practice information to support a learning organization culture, and improved patient outcomes.
NOTE: Special thanks to Jason Uppal, our CEO and Founder of the MillionInnovators Academy for his technical assistance with this project. We are looking for innovative hospitals to collaborate on an upcoming project with sepsis and other hospital acquired conditions using a similar model. If you are interested, please contact me at email@example.com for #ZeroPatientHarm.