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Techno Infection Control

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A data-mining initiative helps California hospitals reduce HAIs—and save money.

Infection control has made a sharp jump up the priority list of many healthcare executives as Methicillin-resistant Staphylococcus aureus and other hospital-acquired infections garner increasing public attention—and cost hospitals a lot of money. Some facilities have responded to growing pressure to prevent the spread of infections by screening more patients, even if they don't exhibit symptoms, but many hospitals are still struggling to find the resources necessary for hospitalwide surveillance.

Eleven California hospitals got some help in their infection control efforts through the first phase of a BlueShield of California Foundation data-mining initiative that uses a comprehensive technology services model to automatically identify and track infection outbreaks. The foundation's California Healthcare-Associated Infection Prevention Initiative monitors antibiotic resistance at the local and state levels, scours data to identify patterns and intervention opportunities, and facilitates meetings between health experts and practitioners so they can share best practices in infection control.

The recently completed 18-month first phase used Cardinal Health's MedMined services to mine the data and help avoid 605 infections at the 11 hospitals. Among the participants, reductions in HAIs resulted in 4,641 fewer hospital days and $2.2 million in bottom-line savings, says Deborah Schwab, BSCF's director of health and technology.

"The reduction was at about 3.2% overall across the hospitals, which is significant," says Schwab. "There were also significant bottom-line savings for the stakeholders."

When the foundation first approached hospitals in 2005 about launching the project, many facilities were not particularly receptive to the idea, Schwab says. At the time, the typical response to the issue of HAIs was, "we don't have a problem," she says.

"There certainly wasn't as much legislative movement around infections as there is now," Schwab says. "Certainly all of the stories around MRSA and acquired infections in our schools and hospitals have really brought it to the forefront."

One hospital that is happy it took the plunge is the 250-staffed-bed Mission Hospital in Mission Viejo, CA. Prior to participating in CHAIPI, Mission Hospital only conducted infection surveillance in critical-care areas because the patients there were most vulnerable, says Debbie Mulligan, RN, infection prevention manager at Mission Hospital. "What the data-mining program does is look at all of your hospital-acquired infections on every unit, so it is housewide," Mulligan says.

Through the CHAIPI, Mission noticed it had a consistent problem with urinary tract infections and focused prevention efforts in that area. "We dropped our hospital-acquired urinary tract infections by 20%," Mulligan says. "In January 2007, we actually started a UTI prevention task force—then we started making inroads on what was really going on and what we could do collaboratively in all the units."

The MedMined services allow for an "apples to apples" comparison for the participating hospitals, Schwab says. Having an objective IT system that is not dependent on individuals and their interpretation of data makes it very standardized from one place to the next, she adds.

California is not the only state employing data-mining technology to fight HAIs—other states, including Pennsylvania, New Jersey, and Alabama, use MedMined for similar infection-prevention programs.

"I think that is the wave of the future—data-mining systems really monitor billions of potential patterns across the hospital to identify actionable information," Schwab says. "You would need a very large staff to do this across most hospitals."

Mulligan agrees, saying that the data-mining techniques used by the CHAIPI are invaluable for hospitals. "Because we had data for all of the units, all of the units could be represented," Mulligan says. "I cannot stress how huge that is, because mostly you are always doing this type of thing with a very small segment of your hospital."

Some of the goals for Phase II of the project will be to help participating hospitals "get to zero" in one to three of their most harmful infection areas and to build initiatives in the hospitals so that they can continue working to eliminate infections after the initiative is complete.

"What we want to do is really attack this problem on many different levels and welcome all hospitals in the state to participate in some form," Schwab says.

Ben Cole

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