McAlearney Ann Scheck, Hefner Jennifer, Robbins Julie, Garman Andrew N
Adv Health Care Manag. 2013;14:69-94. doi: 10.1108/s1474-8231(2013)0000014008.
Despite hospitals' efforts to reduce health care-associated infections (HAIs), success rates vary. We studied how leadership practices might impact these efforts.
DESIGN/METHODOLOGY/APPROACH: 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.
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.
尽管医院努力减少医疗相关感染（HAIs），但其成功率各不相同。我们研究了领导行为如何可能影响这些努力。
设计/方法/途径：我们在开展预防中心静脉导管相关血流感染（CLABSI）举措的医院进行了八项案例研究。在每家医院，我们使用半结构化访谈方案对高级领导、临床领导和一线临床医生（n = 194）进行了访谈。所有访谈均进行了转录并反复分析。
我们发现，各组织和受访者都认为当地临床倡导者的存在是促进HAIs预防工作的关键因素，倡导者在这些举措中担任协调员、支持者和倡导者等重要角色。高层支持也至关重要，受访者重视诸如可见度、承诺和明确期望等要素。价值/原创性：结果表明，领导在成功实施HAIs预防干预措施中发挥着重要作用。增进我们对卫生系统间非临床差异的理解可能有助于消除HAIs的努力。
