Monday, May 05, 2008

Teamwork on Central Line Infections

I received this wonderful report from Blanche Murphy, Nurse Coordinator for the Central Line Service, who knows of my interest in eliminating central line infections. Be sure to check out the site she mentions for an excellent educational tool.

Dear Paul,

I want to share with you a very positive recent experience that I have had at the medical center. Knowing how much you believe in team spirit, I feel that my story is a wonderful example of many people from several areas of the medical center coming together to produce a resource enabling our patients to have safer and knowledge based care. Although many of the functions were done independently, it took all people I mention to produce the outcome.

Three years ago I had an idea to develop a pictorial index on-line allowing staff to correctly identify central venous lines and their appropriate care. It would also serve as an educational tool providing diagrams and pictures to further enhance understanding of central venous access. At the time of this idea, I also initiated a practice change reducing the concentration of heparin we give our patients that would effect the information being given but also entailed major changes to our on-line pharmacy ordering system . On April 16th we went live with a very involved change in the POE system and the debut of the central venous line educational tool.

From the start there were many people who provided their expertise to make this goal achievable. Rich Stroshane from Operations took all of the pictures and Davin Janicki from Healthy Care Quality/ Process Improvement worked endless hours helping put the images into an on-line format. Andy Mackler P.E.V.A. Consultant from Venous Access contributed all the information in regards to PICC lines. Karen Smethers from Pharmacy worked several hours with me establishing a correct ordering system with generated flushing orders for the multiple number of lines we place in our patients. Steve Maynard, Jean Beach, David Feinbloom MD, Jean Hurley from IS, and Kim Sulmonte from Patient Care Services also gave much of their time. Media services' Christophere Ruhle (no longer employed here) and Oran Barber assisted in putting on the final touches to obtain a professional system . Lynn Darrah and Justine Carr were major catalysts for bringing the project to a successful completion with an effective roll out. Although each member of this team developed contributions on their own, it was only when each part worked to together with a team spirit for the final product that the launching could happen.

At you can see for yourself how wonderful the outcome was. By selecting a picture you will be able to view more in-depth information with a link to flushing guidelines insuring a quick reference for staff immediately available. The POE ordering under IV Therapy/IV Access orders also provides not only the correct flush orders for multiple lines but also another way to link to the educational tool.

As I said this was an idea I had three years ago, and if not for the tremendous team work and support from various areas across the medical center it would have never been successfully carried out.

Blanche Murphy


Anonymous said...

Paul, the hyperlink that Blanche included in her letter to you does not work....would you mind reposting? I'd like to see the tool that was created.

I'm the Administrative Fellow at a large hospital in CT. One of my big projects this year (around which I have fit habitually reading your blog!) has been initiating IHI's Central Line Bundle...but we are still struggling. I'm wondering if this approach might work. Thank you, as always, for your wonderful work!

Anonymous said...

Ok, I've tried it by printing out the whole link -- try pasting it in your browser. Hope it works.

Anonymous said...

I'm guessing the link is not accessible outside BIDMC-CareGroup because it's a "home-dev" site. I couldn't get in just by clicking on this link. But I suspect I could if I clicked on it while I was logged into my work account.

Anonymous said...

I fear you are right. Sorry to others. I'll see if I can get public access to it somehow.

Anonymous said...

Should be all fixed now, with thanks to our CIO, John Halamka.