Positive deviance: An inside look
Positive deviance: An inside look
Concept applied to eliminating MRSA
A 250-bed long-term care facility and a 140-bed acute care hospital in Pittsburgh, PA, part of the Veterans Administration Pittsburgh Healthcare System (VAPHS), are applying the concept of Positive Deviance in their efforts to eliminate MRSA from both facilities. (Positive Deviance is described fully at www.positivedeviance.org.)
"We are very early into this process," says Jon C. Lloyd, MD, who serves as liaison between VAPHS, the Pittsburgh health care community, and the Centers for Disease Control and Prevention.
The process began with surveys taken by the entire staff to determine their current level of understanding of MRSA.
Heidi Walker, RN, and Candace Cunningham, RN, coordinators for the MRSA Project, facilitated focus group discussions (FGDs). They talked with more than 350 health care workers from all departments and support services in both facilities; housekeepers, administrators, nurses, physicians, aides and a variety of therapists.
The purpose of the FGDs is to define current practice, barriers to improving performance, and ideas on how to improve.
"All sorts of pent-up observations, insights, and great ideas flowed out of these discussions," according to Lloyd.
The results of the FGDs were written down and reviewed by a core group of staff who volunteered to summarize these findings, along with the results of the surveys and unit-specific quality indicator data, and report back to the staff in a community meeting.
The staff then will select sites where superior results are being achieved in MRSA prevention. The core group of staff volunteers will visit these resource sites, make structured observations to self-discover and learn more about the specific behaviors and practices that enable the staff to implement MRSA prevention precautions reliably and consistently, and then report back to their colleagues in a systemwide community meeting.
Clinical and administrative leaders also will attend the meeting, which is scheduled for December 6, 2005. Jerry and Monique Sternin will facilitate a review of site visit findings and selection of unit-appropriate interventions by the staff and initiate the designing of opportunities to implement them. Professional Practice Councils on each unit will continue this important work.
Lloyd says that "the success of this approach will ultimately depend on the degree to which it is owned and operated by the staff and supported by clinical and administrative leaders. The true measure of success will be dramatic reductions in MRSA infection rates systemwide and improvements that endure, spread, and don’t require a lot of additional resources."
A 250-bed long-term care facility and a 140-bed acute care hospital in Pittsburgh, PA, part of the Veterans Administration Pittsburgh Healthcare System (VAPHS), are applying the concept of Positive Deviance in their efforts to eliminate MRSA from both facilities.Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.