What does your bundle look like?

It’s tough to find a hospital or health system that isn’t diligently working to improve patient safety by reducing the threats posed by antibiotic-resistant bacteria.

Unfortunately, the results of these efforts often vary widely.

If there is a common theme, however, in what makes many facilities successful in reducing health care-associated infections (HAIs), it is that they often employ a carefully assembled bundle of processes and procedures. These interventions typically include a deep commitment to following evidence-based protocols and enhanced communications inside facilities and with outside nursing homes, assisted-living facilities and other partners in the care continuum.

Organizations that excel in reducing HAIs also typically exhibit an organizational commitment to a culture of safety — from the executive suite to the surgical suite to infection prevention professionals to environmental services (ES) leaders and their associates. They capture the right types of data and consistently monitor their measurements and share the results with all pertinent staff.

If you’re wondering what some of these organizations look like, check out our “Trends in Health Care” issue that launched earlier this year. In our Trends report on environmental services, for example, we took an in-depth look at how Orlando Health deployed a bundled approach to sharply reduce hospital-acquired Clostridium difficile, methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci at its South Seminole Hospital facility.

Tom Kelley, M.D., chief of quality and clinical transformation for Orlando Health, explains that his organization’s bundled approach to reducing HAIs includes:

• Stepped up efforts to monitor hand-hygiene compliance, including reporting and auditing findings by department, which led to greater peer accountability. The initiative also included better communication with patients’ families and visitors about the need to practice hand hygiene.

• A carefully detailed approach to employing pulsed xenon ultraviolet light disinfection technology in the intensive care unit, operating rooms and all contact isolation precaution rooms. Once contact isolation rooms are vacated, cleaned and disinfected, they are sealed shut with tape until the next patient enters the room, a move that prevents caregivers or others from entering the room for conversations or other purposes and inadvertently contaminating the space.

• Bagging and labeling of contaminated equipment from rooms of infected patients before the equipment is sent to sterile processing to be disinfected.

• A comprehensive antibiotic stewardship program.

A wide variety of resources are available to help ES teams develop more comprehensive and evidence-based practices that will contribute toward efforts to reduce HAIs in their facilities. But the question to ask now is: What does your bundle look like and how effective is it?

Bob Kehoe is a senior editor with Health Facilities Management.