Translating safety in Spain

Caregivers’ potential to reduce preventable harm and improve patient outcomes is profound. Consider the news that came out of Spain last week from a collaborative of nearly 200 intensive care units. This nationwide effort, with support from the Armstrong Institute at Johns Hopkins, the World Health Organization, the Spanish Health Minister and clinicians across the country, announced that they had reduced central line-associated bloodstream infections by 50 percent.

The recipe for change that they followed is essentially the same as what has worked so well in Michigan and other U.S. states. The ingredients include robust measurement of infections, creating a checklist of evidence-based practices known to prevent them, removing barriers to implementing those practices, and perhaps most importantly, creating a culture of safety in which clinicians believe that improvement is possible. These types of efforts work when they are done as part of a clinical community in which in which all clinicians are actively engaged in the effort to solve a problem, rather than feeling as if it is imposed on them. We have also learned that these programs must be modified to work in the local environment. The Spanish program, called Bacteriemia Zero, was based on the Johns Hopkins program that was put in place throughout the U.S, but the Spanish clinicians modified it to fit their context. They needed to if it was to be successful. (If you speak Spanish, it’s worthwhile to watch a video for Bacteriemia Zero to see how they made this project their own.)

Visit our Stop BSI website to access the free training program to reduce bloodstream infections and improve culture.