The role of leadership in eliminating health care-associated infections: a qualitative study of eight hospitals

Adv Health Care Manag. 2013:14:69-94. doi: 10.1108/s1474-8231(2013)0000014008.

Abstract

Purpose: 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.

Findings: 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.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Catheter-Related Infections / prevention & control*
  • Cross Infection / prevention & control*
  • Hospital Administration / methods*
  • Humans
  • Leadership*
  • Organizational Culture
  • Qualitative Research
  • Quality Indicators, Health Care
  • Quality of Health Care / organization & administration*