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Project JOINTS

The below content was taken from the 2014 BMJ Quality & Safety article on 'Project JOINTS: What factors affect bundle adoption in a voluntary quality improvement campaign?'. A link to the complete article can be found below.

Project JOINTS (Joining Organizations IN Tackling SSIs) was an IHI campaign to spread a bundle of evidence-based practices that can prevent SSI among patients undergoing hip and knee arthroplasty. The resulting five-component enhanced SSI prevention bundle included three evidence-based practices that were not widely used prior to 2010.

Building on previous IHI campaigns, Project JOINTS used a field infrastructure called the Rapid Spread Network (see figure 1) that consisted of three sets of actors: IHI; state organisations, such as Quality Improvement Organisations and state hospital associations, known in the parlance of the campaign as ‘nodes’; and hospitals.

IHI established the agenda, provided recruitment materials, disseminated a ‘How to Guide’, developed intervention materials, created and maintained a project website and email listserv, and offered a range of learning opportunities to participating hospitals

Nodes responsible for raising awareness about Project JOINTS at the state and local levels, recruiting hospitals, disseminating information about the project and helping IHI organise on-site visits and town hall meetings, where participating hospital teams from the same geographical region could come together to openly and informally share their Project JOINTS experiences, learn from each other and get help from IHI faculty in a face-to-face setting.

Model for Improvement

To facilitate implementation of as many evidence-based practices as possible, hospitals were encouraged to use three elements of the Model for Improvement associated with successful QI projects (1) developing a QI plan, (2) putting in place a multidisciplinary implementation team and (3) conducting small tests of change.6 No funding was provided to hospitals to defray costs associated with their participation in this campaign.

This study was designed to test whether adherence to the Project JOINTS QI methods and participation (or ‘engagement’) in Project JOINTS activities could facilitate the adoption of the SSI prevention bundle in hospitals and consequently reduce SSI rates after hip and knee arthroplasty.

Project JOINTS