Big aims lead to big accomplishments
Wynn Roberts’ transition from ICU manager to infection preventionist was serendipitous. When his hospital’s infection prevention director left, Roberts was nominated to fill the position because, he was told, “the ICU is where all the infections are.” Looking back, Roberts is grateful, because infection prevention has been his passion for the past 21 years.
“Being open to big ideas, and new ideas, has been a key for our team,” said Roberts. This philosophy was particularly helpful when, four years ago, the board of directors at Legacy Health announced “Big Aims”, a program designed to eliminate needless deaths and preventable harm, including all healthcare-associated infections (HAIs). “It was daunting,” said Roberts. “It didn’t even seem possible.”
Roberts and his team took on the “Big Aims” challenge by systematically examining every HAI across the Legacy Health system, conducting analyses and then summarizing findings. Roberts engaged key staff members’ participation in regular “drill down” meetings designed to determine root causes and generate practical (and, when necessary, creative) solutions. The team identified many impactful but relatively “easy fix” issues, such as a neonatal ventilator that drained onto a central line and caused infection. Through ongoing collaboration and education, staff members recognized straight-line correlations between infection prevention practices and infection rates.
Soon, what was initially overwhelming became routine. “By involving everyone, from the unit manager to the IV line team, we became increasingly adept at identifying both problems and solutions,” said Roberts.
In the end, “Big Aims” had big results: Over the last two years, Randall Children's Hospital achieved a 53.9 percent reduction in central line-associated bloodstream infections and a 17 percent reduction in surgical site infections. The broader Legacy Health system achieved a 58 percent reduction in combined HAIs during the last three years of the campaign. “We can achieve any objective by solving one problem at a time,” said Roberts.