Kelly Romano

Empowering and Engaging Employees to Reduce Multiple HAIs

Kelly Romano, MPH, CIC
Einstein Medical Center Montgomery
East Norriton, Pennsylvania

Kelly Romano created a culture of empowerment to lead sustained reductions in multiple healthcare-associated infections (HAIs) at her Pennsylvania hospital.

Romano joined Einstein Medical Center Montgomery (EMCM) as director of infection control and patient safety in 2007. “Coming from a public health background, it took me a while to get oriented,” she said. By drawing on her public health experience and actively seeking out resources, Romano was able to quickly begin tackling a daunting challenge: Simultaneously reducing multiple HAIs at her facility.

“Hospital leadership really wanted to see reductions across the board,” said Romano. She created a team of five and appointed individual members to target specific HAIs, starting with central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), surgical-site infections (SSI) and pressure injuries. The teams focused on bedside education, evidence-based practices and direct observation, and met regularly to share observations. “My job was to help these teams develop champions and get the resources they needed,” said Romano. The team eventually grew to 40 champions, comprising what are essentially deputized infection preventionists across the hospital.

While Romano’s teams were having a real impact, some staff remained reluctant to speak up about patient safety issues. “We needed a push for everyone to feel comfortable,” she said. The team began using Just Culture, a program designed to enhance staff confidence in reporting patient safety events. “We’ve seen a real increase in patient safety and a decrease in harm,” said Romano.

CLABSI, SSI and multidrug-resistant organism (MDRO) rates at EMCM have decreased significantly. The hospital’s CAUTI rate is zero.

Romano’s management credits her diligent, passionate leadership for these reductions. Romano, for her part, points to comprehensive engagement. “The change really comes when you have support from the C-suite and staff at the bedside,” she said.