Using quality improvement to reduce hospital-acquired infections: Evaluation of the USAID ASSIST Project in the West Bank
Despite recent gains in health indicators in the Palestinian Territories, evidence from hospital studies suggests that the country is facing a surge in antibiotic-resistant infections due to a lack of standardized infection prevention and control processes and systems. In 2017, together with Ministry of Health (MOH) officials, infection and prevention control and infectious disease specialists in the West Bank, the USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project launched a national-level quality improvement collaborative to build the foundation for a long-term strategy for reducing HAIs in the Palestinian Territories. The nine-month project, implemented from January-September 2017, created a robust learning network among 22 participating hospitals and experts to apply quality improvement methods and tools to establish reliable processes for infection control and prevention, including transmission-based precautions and sepsis detection and treatment; antimicrobial stewardship; improvement of microbiologic laboratory processes and procedures; and active antibiotic management. The learning network included face-to-face, action-oriented learning sessions with teams, monthly quality improvement coaching visits to support hospitals’ processes of change, and technology-driven virtual communities (on video conference and group messaging applications) where collaborative members could share and learn from one another.
This internal evaluation of the HAI collaborative was conducted to understand the progress made in establishing this improvement system over the nine-month collaborative and to provide insights into how and where the initiative was most successful. Specifically, the evaluation sought to determine what effects the intervention had on process and outcome measures, participants’ experience with barriers and enables to improved infection prevention and control, and the development of improvement capability in participating hospital teams.