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HL20: Michael Edmond, MD—Ethics and Results in Infection Control

Cheryl Clark, for HealthLeaders Media, December 13, 2011

"We collect more than 50,000 observations a year, and provide weekly feedback to providers on rates of compliance by each unit in the hospital, and by each type of provider—medical students, nurses, doctors, etc."

At first, hand hygiene compliance was just 40%, but now it is more than 90%, he says.

And the drop in all hospital-acquired infections for all organisms has been remarkable. "From 2003 to the first half of 2011, we've had an 86% reduction in infections in our ICUs, from 21 infections per 1,000 patient days to three. We've had an 84% reduction in central line-associated bloodstream infections and a 93% reduction in ventilator associated pneumonias. One of our ICUs has not had a single ventilator associated pneumonia case in over three years."

In all, he says, the hospital has saved $20 million in avoided cost of treating bloodstream infections, ventilator associated pneumonia, and urinary tract infections in the ICU.

Now, Edmond can say with confidence, "it really appears that you don't have to do active surveillance in order to reduce infections in your hospitals."

VCU is not the only healthcare system to throw out active surveillance for MRSA, but there aren't many other healthcare systems who have adopted this approach, Edmond says. In doing so, he admits to bucking a trend of what he calls "emotional zealotry" that has gotten out of hand.

Advocacy groups began to propel this practice in the mid 1990s, he says, in large part because of sad stories of MRSA tragedies. But what they advocate, and have been successful at achieving, Edmond says, is just not going to get the problem fixed; it doesn't serve the patients or their families and really, it makes matters worse.

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