Why Aren’t We Achieving Better Results? A Literature Review of Healthcare Associated Infection Interventions

Healthcare-associated infections (HAIs) represent a considerable threat to patient and provider safety, healthcare quality, and cost of care. Given the extent of the HAI challenge, there is substantial pressure to reduce and mitigate HAIs. Viewing healthcare as a sociotechnical system (STS) allows us to design interventions to consider all of the STS factors; that is, the internal environment (people, technology, organization, and physical factors) and the external environment (outside influences, politics, policies). Although the clinical indicators of HAIs are well-studied, it is unclear what STS factors have been examined. This paper aims to determine what STS factors have been examined or involved with the development of solutions. The research team identified 213 articles and an in-depth review was conducted. Inventions to address HAIs were classified according to the aspects of an STS which were addressed. This paper summarizes findings and discusses the research gaps. Identification of gaps will allow human factors and health systems researchers design interventions that, if addressed, could potentially reduce HAIs.