Kelley Boston

Integration enables dramatic infection reduction

Kelley Boston, MPH, CIC, CPHQ
Infection Prevention & Management Associates, Inc., and Methodist Healthcare System
San Antonio, Texas

Through motivation and education, Kelley Boston integrated the infection prevention teams across one of the largest health systems in America to dramatically reduce infection rates.

When Boston began working with Methodist Healthcare System in 2011, each of the system’s eight hospitals had enthusiastic but relatively segregated infection prevention teams with varied levels of training and experience. After creating a centralized infection prevention reporting structure, Boston established formal education and advancement plans to help support and grow the infection prevention leaders she saw within each hospital.

She also coordinated regular infection prevention team meetings to share case studies and best practices. “We created real working relationships that enabled easier knowledge sharing,” Boston said. “We converted multiple hospital departments into one integrated system department.”

She stresses that the integration wasn’t always easy. “You need to be open to the fact that you will encounter resistance and intentionally create an environment in which people feel comfortable sharing their concerns,” she said. “Then work to understand the root of these concerns.”

Boston’s interventions have generated impressive returns. For 2015, Methodist Healthcare System established very aggressive goals for reducing central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infections (CAUTI): 30 percent across the board. With the support of leadership, real-time reporting, continuous training and daily accountability for compliance, the system achieved a 43 percent CLABSI reduction and a 29 percent CAUTI reduction – missing the latter 30 percent goal by just one patient. “We used that as a teaching and motivational opportunity,” Boston said. “We asked, ‘Which one patient could we have done better for?’”

For 2016, Methodist Healthcare System has set equally aggressive goals – and Boston is confident they will achieve them. “After hitting such aggressive goals last year, I think everyone finally believes zero is achievable,” she said.