Reducing Three Infections Across Cardiac Surgery Programs: A Multisite Cross-Unit Collaboration

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3 Scopus citations


Using a pre–post design, this study examined the impact of a multifaceted program to simultaneously improve 3 health care–associated infections and patient safety culture throughout the cardiac surgery service line in 11 hospitals. Interventions included the Comprehensive Unit-based Safety Program to improve safety culture and evidence-based bundles to prevent central line–associated bloodstream infection (CLABSI), surgical site infection (SSI), and ventilator-associated pneumonia (VAP). CLABSIs and SSIs showed a downward trend over 2 years, then the rates returned to levels similar to baseline in the third year. VAP rate changes were difficult to interpret because of the VAP definition change. Patient safety culture domain “hospital management support” showed significant improvement, but feedback and communication about errors and staffing declined. Simultaneous implementation of multiple interventions across units is challenging. The findings highlight the importance of sustainment efforts and suggest future work should anticipate both positive and negative change in safety culture dimensions.

Original languageEnglish (US)
Pages (from-to)37-45
Number of pages9
JournalAmerican Journal of Medical Quality
Issue number1
StatePublished - Jan 1 2020


  • handoff
  • infection control
  • patient safety
  • safety culture
  • teamwork

ASJC Scopus subject areas

  • Health Policy


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