Coming "old school" and innovation to reduce HAIs
Elaine Flanagan, RN, BSN, MHA, CIC
Detroit Medical Center
Over the past 15 years, Elaine Flanagan has spearheaded an impressive string of infection prevention achievements at the 2,200-bed Detroit Medical Center (DMC). Flanagan’s supervisor attributes her success to “old school” shoe-leather epidemiology and work ethic combined with an openness to new ideas and innovation. For her part, Flanagan emphasizes the power of data, collective input, and unrelenting patient focus.
“Before proposing a new policy or purchase, know the scientific rationale and do a cost analysis,” she said. “It could be based on just one hypothetical case. Ask the main department that will benefit to help you.”
Flanagan used this approach to lobby successfully for standard central-line insertion trays. “They were expensive, but they saved time and had a real impact on healthcare-associated infections (HAIs),” she said. Flanagan also championed DMC’s transition to an electronic, automated surveillance system. The system integrated the infection prevention function across DMC’s eight hospitals, and significantly impacted HAI rates. DMC central line-associated bloodstream infection (CLABSI) rates declined from 4 in 1,000 central line days in 2003 to 0.27 in 1,000 days in 2011. Rates of “house-wide” CLABSI dropped by 50 percent in the same period. Ventilator-associated pneumonia (VAP) rates declined from more than 7 in 1,000 ventilator days to 0.17 in 1,000 days.
The U.S. Department of Health and Human Services and Critical Care Societies Collaborative recently recognized DMC with an award for success in critical-care VAP reduction.
Collaboration is – in fact – a driving force for Flanagan. “The very first thing you have to do before implementing a new policy is get everyone’s input,” she said.
To facilitate collaboration and feedback, Flanagan developed and chairs multiple interdisciplinary committees – each designed to standardize infection prevention activities, encourage collaboration, generate ideas, identify issues, and share learnings.
“My goal in life is to keep patients safe,” said Flanagan. “I won’t quit and the staff knows I won’t go away. I’m relentless.”