Impact of implementing a method of feedback and accountability related to contact precautions compliance

In January 2002, Infection control professionals for Spartanburg Regional Healthcare System held a planning retreat focused on patient safety. The main challenge discussed was the control of antibiotic-resistant organisms. Rounds on the patient care units had revealed compliance issues with the current isolation procedures. The team developed a process improvement project coined the Effective Processes in Infection Control Project (EPIC). With a broad challenge of antibiotic resistance, the focus was narrowed to isolation precautions for methicillin-resistant Staphylococcus aureus (MRSA).

The initial stage of the EPIC project was education, followed by routine unit rounds to monitor compliance. A tool was developed to provide immediate feedback for the nursing units. Summary reports were generated for clinical directors as a method of accountability for unit leadership. Rates for facility-acquired MRSA were monitored and compared with MRSA days at risk.

Over a 1-year period of increased accountability, the facility-acquired rate of MRSA decreased by 30%, even though the days at risk increased. The decrease was maintained during year 2.

The results of this project point to the importance of accountability with isolation precautions in the effort to combat the spread of MRSA in the hospital setting.