Using a logic model to design and evaluate quality and patient safety improvement programs

Int J Qual Health Care. 2012 Aug;24(4):330-7. doi: 10.1093/intqhc/mzs029. Epub 2012 Jun 27.


Quality improvement programs often pose unique project management challenges, including multi-faceted interventions that evolve over time and teams with few resources for data collection. Thus, it is difficult to report methods and results. We developed a program to reduce central line-associated bloodstream infections (CLABSIs) and improve safety culture in intensive care units (ICUs). As previously reported, we worked with 103 Michigan ICUs to implement this program, and they achieved a 66% reduction in the median CLABSI rate and sustained the reduction. This success prompted the spread of this program to Spain, England, Peru and across the USA. We developed a logical framework approach (LFA) to guide project management; to incorporate the cultural, clinical and capacity variations among countries; and to ensure early alignment of the project's design and evaluation. In this paper, we describe the use of the LFA to systematically design, implement and evaluate large-scale, multi-faceted, quality improvement programs.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Catheter-Related Infections / prevention & control*
  • Humans
  • Intensive Care Units / organization & administration*
  • Intensive Care Units / standards
  • Logistic Models*
  • Patient Safety*
  • Quality Improvement / organization & administration*