2005 HSR&D National Meeting Abstract
1083 — One-Year Follow-Up After a Breakthrough Series (BTS)
Howard Hirschler Kierston
In 2001-2002 we conducted a BTS to reduce falls and related injuries. Our objective was to assess sustainability, spread and successful teams.
One year after project completion (April 29 to August 1, 2003) team contacts were interviewed about sustainability and spread. Team characteristics were assessed through a questionnaire previously completed at the first and second meetings. Sites that spread beyond their facility were additionally interviewed (June 21 to July 1, 2004). Pearson's correlations were used to determine composite team characteristics at the first meeting that predicted success at follow-up, and one year follow up and success. We used a paired t-test to compare the overall fall rate (falls per 1000 bed days of care) for the four "spread" sites (spread beyond their facility) using endpoint BTS data (Dec. 01, Jan. 02) and follow up data (Jan. - March 04). We examined major injury rate (injuries over falls times 100) for the same time frame.
91.9% of teams were interviewed. They reported: 82.4% stayed together as a team, 97.1% continued to collect data, 93.9% maintained gains, 82.4% spread changes, and 84.8% had begun to work on new topics.
The four “spread” sites difference in fall rate at follow up (7.33) compared to endpoint BTS data (4.58) was not statistically significant (t=1.47, p=.239). Three had an average major injury rate of zero with endpoint BTS data; the fourth’s was 5.56. All four had a major injury rate of zero at follow up. Team characteristics in the first meeting correlated with high team performance at one year include: Leadership Support (r = .456, p = .019) and Prior Experience with Quality Improvement and Teamwork (r = .393, p = .047) and at follow-up: Leadership Support (r = .614, p <.001), Teamwork Skills (r=.377, p = .033), and Skills Gained from the project (r = .410, p = .020).
The majority of teams stayed together, continued to collect data, maintained gains, spread and implemented new interventions. Leadership support, experience with quality improvement/teamwork, teamwork skills and skills gained from the project were correlated with achieving and maintaining success.