Excela Health

Engaging Multi-Disciplinary Expertise to Generate Sustained Improvements

JoAnn Grote, BS, MT(ASCP)
Deborah Schotting, RN, MSN, CIC
Excela Health
Greensburg, PA

 By fully leveraging expertise from multiple departments, the infection prevention team at Excela Health effectively tackled rising Clostridium difficile (C. diff) rates at their three-hospital system.

Team leads JoAnn Grote and Deborah Schotting came to infection prevention from different professional backgrounds, so they understood the benefits of varied professional perspectives and experience. “Our department has four infection preventionists – two medical technologists and two nurses,” Grote said. “We feel like this is the ideal mix.”

When a steadily rising C. diff infection (CDI) rate led Excela Health leadership to establish an internal target for reducing or eliminating the infection, the infection prevention team welcomed the creation of an interprofessional team to help improve patient safety. The system’s continuous improvement team leveraged LEAN methodology to bring everyone together and achieve their goals. “We knew we needed a broad range of expertise to achieve our goals and the LEAN facilitator really helped us stay on track,” Schotting said.

Excela Health’s CDI LEAN team created a comprehensive campaign focused on early identification and prevention of C. diff infections through appropriate testing, physician education, isolation/safety zone precautions, antibiotic stewardship, environmental cleaning, and staff and patient awareness.

“We leveraged everyone’s strengths,” Grote said. “It wasn’t just about infection control and nursing.”

In addition to participation from nursing, pharmacy, laboratory, and environmental services departments, the Excela Health marketing and communications department created instrumental tools, team members educated nurses about documentation and process, and the system librarian identified key evidence-based resources.

In just over two years, the system achieved a 43.8 percent reduction in healthcare-associated C. diff infections.

“This outcome alone demonstrates the power of a multi-disciplinary team, but the cultural awareness we generated about each healthcare worker’s role in combatting these infections is just as important,” Schotting said.