It is important to track three types of measures when you are working to reduce healthcare-associated infections (HAIs).
Outcome Measures
These measures tell you whether changes are actually leading to improvement — that is, helping to achieve the overall aim of preventing HAIs. Examples include rate of occurrence of methicillin-resistant Staphylococcus aureus (MRSA) per 1,000 patient days and percent of patients with Clostridium difficile associated disease (CAD).
Process Measures
To affect the outcome measure of preventing HAIs, you will make changes to improve processes intended to prevent transmission of bacteria and other organisms — including the processes for prevention of transmission from patient to patient, staff to patient, and environment to patient. Measuring the results of these process changes will tell you if the changes are leading to an improved, safer system. Examples include percent of patient encounters in compliance with hand hygiene procedure and percent of environmental cleanings completed appropriately.
Balancing Measures
Use these measures to make sure that changes to improve one part of the system aren’t causing new problems in other parts of the system. For example, the change of using a checklist for room cleaning might initially increase the amount of time spent cleaning a room.
These measures were developed as part of the IHI Learning and Innovation Community on Reducing Hospital-Acquired Infections (MRSA, VRE, C. diff) and some were specifically focused on the aim and goals of the Community. These suggested measures can be used by hospitals working to reduce healthcare-associated infections, with local modification and goal setting.
Measures related to reducing healthcare-associated infections have been developed in various IHI programs and initiatives and, while similarities may exist among the different measurement strategies, the measures have often been tailored to the specific aims of the initiative. Organizations seeking to reduce healthcare-associated infections should use measures that fit their particular improvement effort and refer to these suggested measures where useful.
The How-to Guide, developed as part of the IHI Improvement Map initiative, contains suggested measures to track improvement.
The How-to Guide, developed as part of IHI's 5 Million Lives Campaign, contains suggested measures to track improvement.
The How-to Guide, developed as part of IHI's 5 Million Lives Campaign, contains suggested measures to track improvement.
The How-to Guide, developed as part of IHI's 5 Million Lives Campaign, contains suggested measures to track improvement.
The How-to Guide, developed as part of IHI's 5 Million Lives Campaign, contains suggested measures to track improvement.
