The role of leadership in eliminating health care-associated infections: a qualitative study of eight hospitals.
OBJECTIVE
Despite hospitals' efforts to reduce health care-associated infections (HAIs), success rates vary. We studied how leadership practices might impact these efforts.


METHODS
We conducted eight case studies at hospitals pursuing central line-associated blood stream infection (CLABSI)-prevention initiatives. At each hospital, we interviewed senior leaders, clinical leaders, and line clinicians (n = 194) using a semistructured interview protocol. All interviews were transcribed and iteratively analyzed.


RESULTS
We found that the presence of local clinical champions was perceived across organizations and interviewees as a key factor contributing to HAI-prevention efforts, with champions playing important roles as coordinators, cheerleaders, and advocates for the initiatives. Top-level support was also critical, with elements such as visibility, commitment, and clear expectations valued across interviewees. VALUE/ORGINALITY: Results suggest that leadership plays an important role in the successful implementation of HAI-prevention interventions. Improving our understanding of nonclinical differences across health systems may contribute to efforts to eliminate HAIs.
Ann Scheck
AS
McAlearney
Jennifer
J
Hefner
Julie
J
Robbins
Andrew N
AN
Garman
D055499:Catheter-Related Infections / Q000517:prevention & control*; D003428:Cross Infection / Q000517:prevention & control*; D006739:Hospital Administration / Q000379:methods*; D006801:Humans; D007857:Leadership; D015279:Organizational Culture; D036301:Qualitative Research; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care / Q000458:organization & administration*