When clinical leaders at Mercy Health St. Elizabeth Youngstown (Ohio) Hospital first proposed the goal of reaching zero hospital-acquired infections, some physicians balked. It was a lofty, impractical target, some said, given the complexity of the patient population at a level 1 trauma center.
Now, the hospital has been HAI-free for more than 100 days and has surpassed more than 200 days without a single central line-associated bloodstream infection.
Behind this achievement is a commitment to transparency, communication and recognition, according to Gil Padula, MD, chief medical officer and director of case management for Bon Secours Mercy Health’s Youngstown market, and Sally Danilov, BSN, RN, market infection prevention lead.
To gain buy-in from clinicians, leaders had to ensure everyone was fully aware of why reaching and sustaining zero infections was so critical. It’s not just about better reimbursement or achieving a higher CMS star rating, Dr. Padula said. However, leaders don’t shy away from acknowledging those elements as part of the broader equation. Operational metrics matter, but the driving force remains caregivers’ core commitment to delivering safe, effective care to every patient.
“Sometimes you have to personalize it,” Dr. Padula said. “If we had just one infection in 300 days, but it happened to be your wife, you wouldn’t be happy.”
Creating shared accountability across all teams, beyond those providing direct patient care, is also a central part of this goal.
“Environmental is an underrated area,” Dr. Padula said. “Environmental needs to know that the work they’re doing in maintaining a safe environment for our patients is just as important as what the doctors and nurses are doing,” Dr. Padula said. “If they’re doing good work, our patients will have significantly less risk of hospital-acquired infections.”
To support sustained success in preventing HAIs, leaders are also intentional about instilling confidence in nurses and encouraging them to stay curious. Nurses are empowered to ask whether a patient still needs a Foley or central line, and physicians are reminded to anticipate those inquiries as part of a culture committed to patient safety.
“It’s hard work for a young nurse out of school to call an established surgeon and say, ‘I’d like to do the nursing-directed protocol and remove the Foley,'” Dr. Padula said. “It can be very intimidating and we want them to know that we know it is, we support them and we appreciate their work.”
Routinely celebrating progress is another way leaders keep teams engaged and aligned around infection prevention. Every Friday, they recognize another week without an infection, a simple act that reinforces shared goals and sustains momentum.
“We don’t let up,” Ms. Danilov said. “That’s a key thing. We start our morning calls asking clinical teams what they have going on,” in regards to patients with central lines. “It all comes down to consistency, focus and a team approach.”
