(1254) The Use of Infection Prevention Huddles in the ICU: Mitigation of Hospital-Acquired Infections

Introduction: Team failures have been attributed to most errors in patient care. These include failure to communicate, situational awareness and adaptation. These failures have been repeatedly shown to lead to patient harm and unintended outcomes. Huddles have been used in a myriad of systems to help mitigate patient deterioration. Teams are still struggling with undo patient harm from device associated infections despite best practices.

The objective was to develop and implement a team huddle that anchored IP (infection preventionist) to the ICU providers to reduce HAIs.

Methods: A quality improvement project included a multidisciplinary team using a rapid cycle improvement method included a PDSA was conducted. A retrospective review of our hospital HAI rates and failures. A dedicated IP was partnered with the MICU team. Over the course of two months the IP ramped up to cover all MICU teams. Performance was tracked in CLABSI numbers and team awareness. The data collected and reviewed included: communication, collaboration/situational awareness, and equipment and systems issues that were able to have immediate action and correction. Run charts and key driver diagram were utilized to develop and follow progress during the development and institution period.

Results: Huddles were implemented daily and then scaled to three times a week. CLABSI reduction was noted after the start of the huddles for the teams that a period of greater than 2 months. The reduction led to a 56% reduction in CLABSI monthly rate and overall 87% in the team CLABSI rate. The huddle was partnered with a HAI debrief with the clinical care team when a CLABSI occurred. Our debrief and huddle allowed for an improvement process for the CLABSI reduction team with multiple implementations in real time. This has been described in the key driver.

Conclusions: Following principles of High Reliability organizations the IP huddle allowed the team to excel clinically and avoid potential injury and poor outcomes to patients. The multidisciplinary approach to team huddles has improved confidence and communication among the team. Continuing metrics and follow through are needed to see if patient outcomes are sustained by this intervention. Spread is an integral part of QI, and the team has been successful at spread to 3 other ICU provider teams.