Written by Carole W. Kamangu
May 15, 2024
In the third part of our interview with Vanessa Makarewicz, the Director for Infection Prevention and Control of an acute care hospital in Seattle, we discuss the importance of maintaining long-term success in infection prevention and control (IPC) through quality improvement initiatives.
Vanessa describes the challenges and successes her team experienced during the COVID-19 pandemic, and further emphasizes the importance of data, collaboration, and quality improvement in the world of infection prevention and control. Her experience offers valuable lessons for healthcare professionals, more specifically IPC leaders, and healthcare institutions striving to improve patient safety and maintain healthcare quality, especially during challenging times.
The Disruptive Impact of COVID-19
Vanessa reflects on the major disruptions caused by the COVID-19 pandemic. Many of the successes achieved in IPC before this pandemic were diminished during its course, almost requiring organizations to go back to square one. Healthcare organizations were forced to shift their priorities and resources to respond to the global crisis. Often, this was at the expense of other quality improvement efforts and evidence-based practice advancements that were previously made. As a result, IPC teams found themselves in situations where they had to rebuild their relationship with frontline staff and adapt their strategies to address new challenges and changing circumstances.
The Importance of Innovation and Adaptability
Vanessa emphasizes the importance of remaining creative and adaptable. When circumstances are evolving, healthcare organizations should embrace changes to the status quo, consider innovative solutions with a flexible mindset, and adapt their strategies to fit the current context. For example, instead of returning to pre-pandemic practices, Vanessa's team started reevaluating their data and focusing on new areas of concern, such as blood culture contamination rates, to inform their infection prevention efforts.
The Role of Organizational Culture in Infection Prevention Program Success
Organizational culture plays an important role in sustaining quality improvement efforts in IPC programs. An organization that values continuous improvement, data-driven decision-making, and prioritizes patient safety is more likely to support ongoing quality improvement initiatives. When leadership understands the role and positive impact of infection prevention and control within their facilities, especially in the context of patient outcomes and financial implications, they can provide the necessary resources and support for these efforts. Vanessa attributes the continuous engagement and support from leadership to the long-standing organizational culture cultivated within her facility. This culture has so far contributed to strengthening the IPC program and its initiatives thus promoting patient safety and reducing the costs of healthcare delivery.
The Importance of Keeping the Pot Simmering Despite the Challenges
Watch the conversation on YouTube
Despite the challenges of sustaining its quality improvement initiatives, Vanessa's team's approach remains focused on continuous learning and collaboration with frontline staff. She acknowledges that maintaining sustainable results in infection prevention and control is an ongoing journey and that there may not be a one-size-fits-all approach.
She further emphasizes the fact that sustaining quality improvement initiatives is often more challenging than initially implementing them. To ensure that improvements are maintained over the long run, she compares the process to keeping a "pot of water simmering.”
“And the way that I like to think about it in my mind, and I think you probably have heard this many times from me, is that quality improvement, especially infection control initiatives, you have to always have the pot simmering. So, say you do really well in CLABSI. You can't just turn the pot off and let it get cold. You have to keep that water simmering somehow.” - Vanessa Makarewicz
Each organization should adapt to its evolving needs and tailor its initiatives to fit its internal cultural context while managing the resources available. For example, achieving positive results in reducing healthcare-associated CLABSI (Central Line-Associated Bloodstream Infections), is a significant accomplishment. However, simply achieving these results is not enough; they must be maintained over time, and that's when organizational culture comes into play and ongoing collaboration within the organization must be nurtured.
Vanessa provides valuable insights into the difficulties of sustaining the success of infection prevention and control initiatives in the long run. By maintaining a continuous improvement mindset, IPC teams can drive change within their organizations while continuing to engage the frontline in promoting patient safety at the bedside. Healthcare organizations must be willing and prepared to innovate, collaborate, and use a data-driven approach to decision-making while prioritizing patient safety. Challenges are ongoing, but with the right approach and organizational culture, sustaining quality improvement initiatives in infection prevention is possible, even in the face of world-changing events like the COVID-19 pandemic.
In the next part of our blog series, we will start the conversation with another program leader, exploring the challenges and successes of maintaining the quality of an infection prevention and control program in the context of a distinct geographical setting.
Did you miss part II of this blog series? Read more of Vanessa's insights here.
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About Our Guest
Vanessa A Makarewicz received her Bachelor’s in Nursing from the Johns Hopkins School of Nursing where she was a Fuld Fellow and researched the incidence of infections from vascular access devices. In 2004, she moved to Seattle and began working on 5NE, a cardiothoracic surgery floor at University of Washington Medical Center. In June 2008, she received her Master’s degree from the University of Washington as an Infectious Disease Clinical Nurse Specialist. She practiced for four years as a Clinical Nurse Specialist at UWMC with the focus on decreasing central line infections as it relates to insertion and maintenance. Currently, she is the Infection Prevention & Control Director at Harborview Medical Center and continues to be an advocate for patients and staff in the Quality Improvement and Infection Prevention specialties. She has been at UW Medicine for 20 years and at HMC for 11 years.
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