From 2006 to 2008, investigators with the Plexus Institute developed a pilot program at six hospitals to control and reduce the rate of infections of methicillin-resistant Staphylococcus aureus (MRSA), one of the most virulent hospital-acquired infections in the United States.
Investigators used an approach called positive deviance, which identifies individuals and groups within an organization or community who have overcome seemingly intractable problems and spreads their solutions throughout the organization.
- Six institutions participated in the pilot project:
- Albert Einstein Medical Center, Philadelphia, Pa.
- Billings Clinic, Billings, Mont.
- Franklin Square Hospital Center, Baltimore, Md.
- University of Louisville Hospital, Louisville, Ky.
- The Johns Hopkins Hospital, Baltimore, Md.
- VA Pittsburgh Healthcare System, Pittsburgh, Pa.
- MRSA rates declined by 73 percent in four of the six pilot units. Two of the six institutions did not report unit-level data.
- The aggregate rate of MRSA infections per 1,000 patient days dropped from 4.36 in 2006 to 1.17 in 2008 among the four pilot hospital units that reported.
- Three of the six hospitals expanded the approach from the initial pilot units to at least one other unit.
- Three hospitals adopted the project throughout their entire institutions.
- The results achieved by the pilot institutions spurred 53 additional hospitals in the United States, Canada and South America to adopt the positive deviance approach in their drives to prevent MRSA transmission.
While the need to address disparities in care is well known, few strategies for reducing disparities have been studied systematically.
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