After developing the observation tools, the collaborative deployed a pilot program at three U.S. Hospitals. It was important that the pilot participants reflect the diversity of healthcare facility type, size, and location. As such, the volunteer organizations included a large academic tertiary care facility (Vanderbilt University Medical Center, Nashville, TN), a 270-bed acute care community hospital (Summit Health-Chambersburg Hospital, Chambersburg, PA) and a 25-bed critical access hospital (Central Montana Medical Center, Lewistown, MT). Their feedback helped finalize the observation tools.
Central Montana Medical Center piloted the observation tools in both their critical access hospital as well as their busy outpatient clinic. In the hospital, nurses, phlebotomists, nursing assistants, clerks, and housekeepers used the tools in true team fashion throughout multiple areas. Non-nursing staff were especially enthusiastic about participating. Denise Jimmerson, RN, Infection Preventionist noted that the “…tools sparked some conversation for staff regarding safe patient practices…Staff began to connect the dots that the environment and available supplies support infection prevention behaviors such as hand hygiene.” Meanwhile, seven clinic offices participated in the ambulatory setting. Observers rotated outside of their specific work environments to conduct assessments in nearby clinics. Barb Berg, RN, noted “Using the QUOT tool was great for team building” and the team celebrated completing the pilot with clinic staff with a group exercise of “What’s MY Role in infection control?”
At Summit Health-Chambersburg Hospital the implementation was launched through their Patient Care Council. Infection preventionists piloted the tools for the first week and then began training frontline staff for ongoing observations. Ericka Kalp, PhD, MPH, CIC, FAPIC, Director, Epidemiology and Infection Prevention observed that “Rounding with QUOT tools helped to spark collegial conversations about patient safety.” She further acknowledged that there were some initial concerns. “Staff had perceived that QUOT tools would be a laborious process, but attitudes changed after using the tools because it took just a few minutes to perform.”
Vanderbilt University Medical Center was the first organization to receive the APIC Program of Distinction Award. With over 22,000 employees, the observation tools were piloted across 10 different departments/units including multiple intensive care units and procedural areas. Participants at Vanderbilt found the tools were easier to use than their established, organization safety round checklists and that the findings could be shared during daily safety huddles. Vicki Brinsko, MSN, RN, CIC, FAPIC, Director Infection Prevention commented: “[I] Recommend using the tool for audits-they are simple to use and help in prepping for surveys.”