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 – 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

Patient ID GenderDate of

BirthNHSN Procedure

CodeDate of

Procedure Outpt.Duration

HoursDuration Minutes

Wound Class

ASA Class Endoscope

Surgeon Code

NHSN SSI Denominator Data

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 TimelineMedical/Surgical ICU CLABSI Reporting January 1, 2009

Pediatric/Neonatal ICU CLABSI Reporting October 1, 2009

SSI NHSN Training February 2010

Initial Outbreak/Breaches of IC Practices Workgroup Meeting

February 2010

Training and launch of Chicago area C. difficile Collaborative

March 2010

SSI Reporting for TKA and CABG April 1, 2010

MDRO Workgroup Meeting 2010Long Term Care Workgroup Meeting 2010

SSI TKA and CABG Data Available January 2011HAI Workgroup Meeting February 2011

MRSA and C. difficile Reporting Through NHSN Statewide

2011

Surveillance Workgroup Meeting 2011

Questions