Transcript Illinois Healthcare-Associated Infections (HAI) Plan

Illinois Healthcare-Associated
Infections (HAI) Plan
Mary Fornek
January 21, 2010
Metropolitan Chicago Healthcare Council
American Recovery and
Reinvestment Act of 2009
(ARRA)
Four Components of the HAI Plan
• HAI Program Infrastructure
• Surveillance, Detection, Reporting and
Response
• Prevention
• Evaluation, Oversight, and Communication
HAI Program Infrastructure
Key Points
• Illinois has created a HAI Prevention
Advisory Council
• Specific HAI targets have been identified
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Clostridium difficile (C. difficile)
Methicillin-resistant Staphylococcus aureus (MRSA)
Central line Associated Bloodstream Infections (CLABSIs)
Surgical Site Infections (SSIs)
Surveillance, Detection, Reporting
and Response
Central Line Associated
Bloodstream Infections
(CLA BSIs)
• Statewide reporting of CLABSIs in adult
medical and/or surgical ICUs using
National Healthcare Safety Network
(NHSN) began January 1, 2009.
• Statewide reporting of CLABSIs in
Pediatric and Neonatal ICUs began
October 1, 2009.
CLABSI continued
• Baseline CLABSI standardized infection
ratios (SIRs) for various ICU types for the
first twelve months of NHSN surveillance
will be available by March 1, 2010.
• The IHA is a participant in John Hopkins
University’s nationally recognized
multistate “Stop BSI” initiative, in which
forty-one Illinois hospitals are enrolled.
Clostridium difficile Collaborative
• Implementation in March 2010
• 20 hospitals will be asked to participate
– 10 hospitals from the Chicago area
– 10 hospitals from Southern Illinois
• Hospitals participating in the C. difficile
collaborative will be required to use the
NHSN (C. difficile Associated Disease)
CDAD module for reporting.
Methicillin Resistant
Staphylococcus aureus (MRSA)
• October 1, 2007 – hospitals identify patients
colonized and/or infected with MRSA.
• MRSA data available on the IDPH website in an
annual report and on the Hospital Report Card.
• http://www.healthcarereportcard.illinois.gov
• IFMC-IL MRSA Collaborative
– Includes 8 hospitals, all reporting
MRSA through the NHSN MDRO
module
Surgical Site Infections (SSIs)
• Statewide Reporting will be required in
APRIL 2010
• 2 Procedures
― Total Knee Arthroplasty (TKA)
― Coronary Artery Bypass Graft
(CABG)
SSI Workshops
• Mary Andrus presenting SSI Module of NSHN
– February 5, 2010 MCHC
– February 12, 2010 Elmhurst Health Center
– March 5, 2010 New Sherman Hospital
• Two 4 hour sessions each day
• (8am – 12pm) and (1pm – 5pm)
• 30 participants per session
•
IT Webinar – date to be determined
NHSN
SSI Denominator Data
Patient ID
Gender
Date of NHSN Procedure
Birth
Code
Date of
Procedure
Outpt.
Duration
Hours
Duration
Minutes
Wound
Class
ASA
Class
Endoscope
Surgeon
Code
Electronic Lab Reporting (ELR)
Surveillance
• Automated reporting of reportable diseases
to public health agencies
• Development of software modules to
increase the efficiency and reliability of
reporting to CDC’s National Healthcare
Safety Network
• Linking together hospitals to identify transfers
of patients for whom a multi-drug resistant
organism (MDRO) has been detected
Key Points
• Two priority prevention targets for
surveillance have been identified (e.g.
CLABSI and SSI).
• Illinois hospitals with adult, pediatric, and/or
neonatal ICUs are required to report
CLABSIs through NHSN.
• Illinois hospitals are required to report TKA
and CABG SSIs through NHSN beginning
April 1, 2010.
Prevention
Development of 5 Workgroups
• MDRO Workgroup
– Will explore making all or some of the specific
emerging multidrug-resistant gram negative
organisms of epidemiologic importance reportable in
the State of Illinois.
• HAI Workgroup
– Establish outbreak reporting requirements
– Explore methods to electronically achieve notification
of HAI outbreaks
– Explore developing a separate module for reporting
HAI clusters within the current reporting systems
Workgroups continued
• Outbreak/Breaches of IC Practices Workgroup
– Explore developing processes and tiered response
criteria to handle increase reports of serious infection
control breaches or suspect cases/clusters, and
outbreaks
– Decide on actions that will be taken when serious
infection control breaches have been identified
• Surveillance Workgroup
– Explore developing legislation to mandate use of
qualified electronic surveillance system and minimum
Infection Preventionist staffing levels
Workgroups continued
• Long Term Care Workgroup
– Assist in developing a statewide needs
assessment and profile
– Establish educational standards for LTC
and LTACH healthcare workers
– Develop standardized educational tools
– Implement the educational sessions
– Explore current and future collaboratives
between local health departments and
LTCF, LTACHs and hospitals
Evaluation and Communication
Key Points
• IDPH will be measuring progress towards
targets through NHSN data.
• Validation activities will be implemented
throughout the year.
• Consumers have access to healthcare
quality measures through the Illinois
Hospital Report Card Web Site
Activities
Timeline
Medical/Surgical ICU CLABSI Reporting
January 1, 2009
Pediatric/Neonatal ICU CLABSI Reporting
October 1, 2009
SSI NHSN Training
Initial Outbreak/Breaches of IC Practices Workgroup
Meeting
Training and launch of Chicago area C. difficile
Collaborative
SSI Reporting for TKA and CABG
MDRO Workgroup Meeting
Long Term Care Workgroup Meeting
SSI TKA and CABG Data Available
HAI Workgroup Meeting
MRSA and C. difficile Reporting Through NHSN
Statewide
Surveillance Workgroup Meeting
February 2010
February 2010
March 2010
April 1, 2010
2010
2010
January 2011
February 2011
2011
2011
Questions