title: Using a logic model to design and evaluate quality and patient safety improvement programs.
abstract: Quality improvement programs often pose unique project management challenges, including multi-faceted interventions that evolve over time and teams with few resources for data collection. Thus, it is difficult to report methods and results. We developed a program to reduce central line-associated bloodstream infections (CLABSIs) and improve safety culture in intensive care units (ICUs). As previously reported, we worked with 103 Michigan ICUs to implement this program, and they achieved a 66% reduction in the median CLABSI rate and sustained the reduction. This success prompted the spread of this program to Spain, England, Peru and across the USA. We developed a logical framework approach (LFA) to guide project management; to incorporate the cultural, clinical and capacity variations among countries; and to ensure early alignment of the project's design and evaluation. In this paper, we describe the use of the LFA to systematically design, implement and evaluate large-scale, multi-faceted, quality improvement programs.
authors: Department of Anesthesiology and Critical Care Medicine, School of Medicine, Armstrong Institute for Patient Safety and Quality, JohnsHopkins University, Baltimore, MD 21231, USA. cgoesch1@jhmi.edu
authors: Christine A
authors: CA
authors: Goeschel
authors: William M
authors: WM
authors: Weiss
authors: Peter J
authors: PJ
authors: Pronovost
mesh_terms: D055499:Catheter-Related Infections / Q000517:prevention & control*; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration* / Q000592:standards; D016015:Logistic Models; D061214:Patient Safety; D058996:Quality Improvement / Q000458:organization & administration*