# Searching for Management Approaches to Reduce HAI Transmission (SMART)

> **NIH AHRQ R01** · OHIO STATE UNIVERSITY · 2021 · $359,034

## Abstract

Project Summary/Abstract
In hospitals, healthcare-associated infections (HAIs) impact the lives of patients through prolonged
hospitalization, morbidity, and death, and result in significant financial costs to both health systems and
society. Central line–associated bloodstream infections (CLABSIs) and catheter-associated urinary tract
infections (CAUTIs) are considered two of the most preventable types of HAIs. Despite the availability of
clinical evidence-based reduction strategies, hospitals vary in abilities to successfully reduce CLABSI and
CAUTI rates. Efforts to apply clinical evidence to practice through the Comprehensive Unit-based Safety
Program (CUSP) and similar programs have also shown mixed success, and have been largely limited to ICU
environments. Moreover, research suggests variation in success is due to a lack of guidance on management
practices that address the context in which CLABSI- and CAUTI-prevention efforts take place. Thus there is a
need to explore how to successfully translate HAI-reduction efforts such as CUSP to non-ICU settings (clinical
practice), and how to shape context (management practice)--including both culture and management strategies--
to proactively support clinical teams.
Our proposal, Searching for Management Approaches to Reduce HAI Transmission (SMART), builds on
prior work to explicate and operationalize management practices that were suggested to be associated with
successful CLABSI-reduction efforts, as well as expand these practices to promote CAUTI reduction. We
employ a mixed-methods approach in three phases to (1) develop valid and reliable measures of structural
management practices for use as a survey (HAI Management Practice Guideline Survey) that can be used in
both medical/surgical units and ICUs; (2) administer the HAI Management Practice Guideline Survey within
Ohio hospitals to determine the positive predictive value of the measurement instrument as it relates to
CLABSI- and CAUTI-prevention, and expand survey data collection to a national sample; and (3) integrate
these findings into a Management Practices Toolkit that includes an organization-specific data dashboard for
monitoring progress in support of HAI-prevention efforts, and disseminate the toolkit nationwide. The SMART
Toolkit we develop will contain three components: (1) an Online Survey Platform, (2) Visualization and
Dashboarding, and (3) an Implementation Training Program. Hospitals will thus be able to use the SMART
Toolkit to answer the questions – how is my hospital doing, in both absolute and relative terms, and what can I do
to impact my outcomes – using real-time reporting tools and with guidance about implementing structural
management practices that have proved effective at improving patient safety at other hospitals across the nation.

## Key facts

- **NIH application ID:** 10133041
- **Project number:** 5R01HS024958-05
- **Recipient organization:** OHIO STATE UNIVERSITY
- **Principal Investigator:** Ann Scheck McAlearney
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2021
- **Award amount:** $359,034
- **Award type:** 5
- **Project period:** 2017-04-01 → 2023-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10133041

## Citation

> US National Institutes of Health, RePORTER application 10133041, Searching for Management Approaches to Reduce HAI Transmission (SMART) (5R01HS024958-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10133041. Licensed CC0.

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