4 Development and implementation of a quality control system: Albert Einstein hospital experience

<h3>Background</h3> Institutions make big efforts to improve their processes, however, there is a lack of planning and investment regarding the quality control system. Thus, building an integrated quality control system is crucial to achieve high reliability. <h3>Objectives</h3> To increase the number of tools integrated into the care routine (related to the Quality Control System – see figure 1) from one to at least eight routine changes within six months from the program launch. <h3>Methods</h3> The presenting program named “SOMOS Prevenção de Infecção” (We are Infection Prevention) used the Model for Improvement to develop and implement a Quality Control System to prevent Healthcare Related Infections. It was organized in two steps: 1. training on technical, adaptative skills and also in the model for improvement. 2. test and implement the changes that had succeeded. <h3>Results</h3> As result, the units were able to implement sustainable changes in the routine which reduced infection Central line-associated bloodstream infection (CLABSI) (figure 2) and Catheter-Associated Urinary Tract Infection (CAUTI) (figure 3) rates in 54% and 100%, respectively. It also increased the hand hygiene adherence from 79 to 89%, CLABSI prevention bundle from 79% to 89% (figure 4) and CAUTI prevention bundle from 89% to 92% (figure 5). <h3>Conclusion and Implications</h3> Juran’s trilogy proposes three phases in quality – planning, improvement and control. Therefore, it is crucial to develop and implement a quality control system to sustain results. In some situations, may be necessary to develop an improvement project to achieve a Control System or include quality control components since the beginning of Improvement Projects.