Healthcare-Associated Infection Prevention in Minnesota
Healthcare-associated infections (HAI) are a serious patient safety issue, and reducing HAIs is a national priority. In 2009, the U.S. Department of Health and Human Services developed an action plan with national goals for reducing HAIs, and provided funds through the American Recovery and Reinvestment Act (ARRA) for each state to develop and implement its own HAI Action Plan.
The Centers for Medicare & Medicaid Services has identified HAIs as one of three high prevalence, high cost clinical topics. CMS designed its nationwide Quality Improvement Organization (QIO) Program to lead local improvement initiatives for health care providers and stakeholders to reduce HAIs. Stratis Health, as the Medicare QIO for Minnesota, is leading this work for CMS within the state.
Minnesota statewide HAI plan
Minnesota formed the HAI Advisory Group, representatives from key organizations involved in HAI prevention, to guide the development of the Minnesota HAI Plan with measurable goals and objectives that complement existing Minnesota HAI prevention efforts to ensure Minnesota's progress toward national HAI prevention targets.
Minnesota Healthcare-associated Infections Prevention Plan (20-page PDF)
 Collaborative healthcare-associated infection network (CHAIN)
In 2011, Stratis Health, Associated Professionals in Infection Control – Minnesota (APIC-MN), the Minnesota Department of Health (MDH) and the Minnesota Hospital Association (MHA) APIC-MN. MDH and MHA formed the collaborative healthcare-associated infection network (CHAIN). The partnership was formed to develop and carry out effective approaches for reducing healthcare-associated infections in Minnesota. HAI prevention goals will be achieved through interventions focused on hand hygiene, transmission precautions, injection practices, antimicrobial stewardship, and environmental cleaning. The comprehensive unit-based safety program (CUSP) will be used to initiate catheter associated urinary tract infections (CAUTI) prevention efforts.
Stratis Health is supporting CHAIN through July 2014 as part of its QIO work. Hospitals that participate in QIO initiatives can expect to receive technical assistance for reporting HAI data, as well as opportunities for peer-to-peer learning through the statewide learning and action network, access to and training on evidence-based tools like the central line checklist, support for rapid-cycle improvement, and strategies for spreading success within their hospital.
Targeted infections
The partnership will focus on the prevention of:
- CAUTI: catheter associated urinary tract infections
- CDI, C. diff: clostridium difficile infections
- CLABSI: central line associated bloodstream infections
- CRE: carbapeneum-resistant enterobacteriaceae
- MRSA: methicillin-resistant Staphylococcs Aureus
- SSI: surgical site infections
- VAP: ventilator associated pneumonia
Targeted settings
Initially targeted to hospitals, the project will extend to ambulatory surgery centers, long-term acute care rehabilitation facilities, clinics, nursing homes, and home care agencies. This work will align with the work of other groups focusing on patient safety, reportable events, transitional care at the bedside, quality reporting and improvement, and improving preventive health by achieving meaningful use of electronic health record systems.
Resources
Blood Culture Template. Validation of the Central Line-Associated Bloodstream Infection (CLABSI) measure will begin with the FY 2014 payment. Hospitals selected for validation are required to provide a quarterly list of all blood cultures positive for infection taken from intensive care units, using the Blood Culture Template. The blood culture list will be used to facilitate the validation of the CLABSI measure. (3-worksheet Excel doc)
Clostridium Difficile: Communications Resources for Hospitals. The Centers for Disease Control and Prevention provides the following communications resources for hospitals working to prevent Clostridium difficile.
Patient Safety, Zero is Achievable. Comprehensive Unit-based Safety (CUSP), an intervention to learn from mistakes and improve safety culture. Presented by David Thompson, DNSc, MS, RN, Assistant Professor, The Johns Hopkins University and The Johns Hopkins Health System Corporation, November 9, 2011. (43-minute audio file)
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