Achieving Clostridioides difficile infection Health and Human Services 2020 goals: Using agile implementation to bring evidence to the bedside

Abstract

Clostridioides difficile infection (CDI) is the leading cause of hospital-acquired infections (HAI) in the United States. 1 Although multiple interventions have been shown to reduce CDI, the adoption of these evidence-based practices remains suboptimal, and the burden of CDI remains high. 2 There is a pressing need to develop strategies that bridge the gap between the available evidence and clinical practice to reduce harm from CDI. The 'Agile Implementation' (AI) framework was used to reduce central-line-associated bloodstream infections (CLABSIs) at our institution. 3 In study described here, we used the AI model to achieve reductions in CDI. Methods Setting The study was conducted in 2 large academic hospitals in the

Utilizing a real-time discussion approach to improve the appropriateness of Clostridioides difficile testing and the potential unintended consequences of this strategy

“…Our framework was based on the agile implementation model, which we have successfully utilized to improve hospital-acquired infections. 10,11 Quality improvement projects can fail due to technical or 'adaptive' challenges, and the latter have more to do with attitudes and beliefs rather than knowledge. 12 In this study, we show a consistent and sustainable reduction in CDI testing that was brought about by changes in clinician behavior that was not tied to soft or hard EMR-based interventions.…”