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Prevention Collaborative Q and A

 

What is the CDC definition of a prevention collaborative?

A group of facilities that are engaged in an effort to improve an outcome, in this case to reduce HAIs.  The members of the collaborative should use a common, though not necessarily identical, approach.  The members discuss progress regularly and share lessons learned in real time so that others in the group can benefit from the experience of each facility.

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Is there a minimum size (number of facilities) for prevention collaboratives?

Meaningful collaboration can take place whenever two or more facilities are working together. The ideal size of a collaborative can depend on many factors, including the specific subject of the prevention collaborative,  the level of resources available for supporting inter-facility interaction, the type of collaborating facilities, the level of enthusiasm, and the type of intervention strategy being implemented. Collaboratives that are implementing interventions that are more “cutting edge” or resource intensive might work best with a smaller number of facilities (e.g. 5-10), at least initially. Collaboratives that are focused on implementing more well established “change packages” (e.g. improving central venous catheter insertion practices), can be quite large (e.g. >30).  Perhaps the most important factor in determining the size of the collaborative is the number of facilities expressing a sufficient level of enthusiasm and engagement to sustain the collaboration. If very few facilities exhibit an enthusiastic willingness to participate, it might be best to limit the size.

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What is the minimum number of collaboratives a state needs to engage in?

Any state that's funded for Activity C should be engaged in at least one prevention collaborative.

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What can states that did not receive any Activity C funding, or received limited funds, do to develop successful collaboratives?

States should partner with their multi-disciplinary HAI advisory committee/council to discuss options and ideas for prevention activities.  Where appropriate, they too can begin to plan for and/or develop a prevention collaborative using the framework and tools provided by the CDC such as the “Cookbook to Collaboration.”

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Should prevention collaboratives monitor both process and outcome measures or focus on just one or the other?

It can be helpful to collect both outcome measures and process measures simultaneously. However, process measures should be viewed primarily as a tool to assist implementation efforts.  

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Should a prevention collaborative focus only on data currently collected through NHSN surveillance, or should one branch out to collect additional data not currently part of NHSN surveillance efforts?

We consider the NHSN outcome and process measures the most important measures to focus on for ongoing data collection and reporting by facilities engaged in a collaborative.  With that said, we encourage coordinators to assess baseline prevention policies, procedures, and practices in participating facilities and to track changes in facilities’ approaches to prevention throughout the collaboration. To this end, example standardized questions and survey instruments will be provided.  Although such ongoing assessment is optimal and to be desired, care should be taken to ensure that the data collected are limited to only what is most useful, realizing that effort toward additional data collection might come at the expense of effort dedicated to implementation of interventions.

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Should a prevention collaborative interested in focusing on both CLABSI and SSI be considered two distinct entities, or one collaborative with two foci?

Different prevention projects may require different stakeholders.  Therefore, it may be necessary to treat these as two distinct collaboratives, since different persons/facilities may be involved.  Advisory groups, meetings, and communications also may need to be distinct from each other (although a larger informational meeting combining the two could be helpful and would encourage shared learning's as appropriate).

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Is it appropriate to focus on CLABSI prevention collaborative for year 1 and SSI prevention collaborative for year 2?

It is fine to implement these two collaboratives using a “phased-in” approach; i.e. beginning the CLABSI collaborative now and the SSI collaborative later.  However, we encourage states to begin planning early for the later collaborative, so that on the “launch date” all partnerships and logistics are in place.  There is no need to wait for the beginning of year 2; if resources allow, the later collaborative could begin earlier than that (e.g. six months into year 1).

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Can we combine facility types for a prevention collaborative; for example: long-term care facilities and acute- care facilities for CLABSI, and ambulatory surgery centers (ASC) and hospitals for SSI?

This is acceptable and encouraged, as it might provide important information about differences in prevention and outcome measures potentially inherent to these distinct healthcare settings. In such cases, the collaborative might find it helpful to support a “collaborative within a collaborative”. For example, ASC's may benefit from some focused interfacility collaboration with other ASCs, even within the context of the larger SSI collaborative involving a more heterogeneous group of facilities.

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For guidance on what types of resources (financial, staff) are needed to support a collaborative:

Go to the Collaborative Cookbook.

For information on measurement within the collaborative- what to measure, how to measure it, how to validate data:

Link to the specific HAI infection-specific toolkits.

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