Continuous Quality Improvement
Targeted Solutions Tool
The Targeted Solutions Tool™ (TST) is an online application developed by the Joint Commission Center for Transforming Healthcare to help Joint Commission accredited organizations solve some of the most persistent health care quality and safety problems.
The TST guides organizations through a step-by-step process to accurately measure actual organizational performance, identify organizational barriers to excellent performance, and then direct the organization to proven solutions that are customized to address their particular barriers. The TST also provides tips and guidance for sustaining a comprehensive improvement process.
The TST is available for use in three areas as of November 2012: improving hand hygiene compliance, reducing the risk of wrong site surgery, and improving hand-off communications. It will be expanded in the future to include solutions for other Center projects, including surgical site infections, heart failure hospitalizations, safety culture, preventing falls, and sepsis.
NMCP is devoted to improving our performance in hand hygiene compliance. In the winter of 2011, NMCP adopted the WIWO (wash in and wash out) hand hygiene campaign. As a result, our compliance rates increased but we knew we could do better. We implemented the use of the TST for hand hygiene compliance in January 2013. The TST provided us the foundation and framework of an improvement method that assisted us to significantly improve our hand hygiene compliance thereby contributing to our efforts to reduce the frequency of heath care associated infections. We are excited and pleased to share our results!
TST: Hand Hygiene
During the development of the Hand Hygiene TST, the Center for Transforming Health Care worked with eight of the country’s leading hospitals and health care systems to use systematic process improvement methods to identify targeted solutions to tackle hand hygiene compliance. At the start of the project hand hygiene compliance averaged 48 percent. Within eight months, the average rate increased to 82 percent.
Other hospitals across the country to include small, medium and large facilities collaborated with the Center to test the original work and provide input into the development of the TST. All these hospitals experienced similar increases in hand hygiene compliance. Since its launch in 2009, the TST has collected over 400,000 hand hygiene observations. This data has demonstrated that organizations are able to significantly improve their compliance with hand hygiene when utilizing the TST. On average, the Center reports that organizations have improved 46 percent above their baseline rates with long term sustainment in compliance.