Real-Time Infection Protection

In the early utilization of the MedMined service, HUMC ran NIM scorecards for each inpatient unit and the hospital overall and discovered the most common type of NIMs were urinary tract infections. To determine where to focus, ICPs decided to perform a staff knowledge assessment. Results showed additional staff education was needed on the process for inserting and maintaining a Foley catheter. As a result of these efforts, we have seen the number of urinary NIMs decrease dramatically.

The previous system of surveillance would not have been able to reveal the intricacies of this problem. ICPs wouldn't have been able to identify a specific source to focus a manual system. MedMined has helped our ICP team identify numerous unit-specific issues. Time which was previously spent on data review is now used to review processes that lead to infection prevention.

Outbreak management is critical. MedMined identified the existence of a recent outbreak and allowed infection control staff to identify the index case on the specified unit. We entered the information for the infection we were looking for, according to pathology and time parameters, and MedMined provided a list of all the patients who were affected on the specified unit. The sheer enormity of the data required to perform the outbreak investigation would have made this task impossible using manual surveillance.

Another benefit of the service is how it has enhanced the role of the ICP at HUMC. The opportunity to provide clinicians with actionable data has allowed professionals to have a much greater impact on infection rates. Being able to say to caregivers "Here's the problem and here's how we can fix it," has changed the perception of infection control at HUMC. The infection control staff now spends a great deal of time interacting with the nurses and doctors on a daily basis.

Results

In September of 2005, when Horizon Blue Cross Blue Shield launched NJIPP, we sought to repeat the success of other hospitals participating in similar initiatives. Our goal was a modest single-digit infection reduction rate. The first outcomes analysis of the initiative was performed after approximately nine months of utilization. At that time, Horizon BCBS saw a 10.31 percent decline in the infection rate within the participating hospitals. With a 10.31 percent reduction by June of 2006 — nine months into the program — HUMC had averted more than 150 infections, which resulted in significant cost savings. Based on the early successes of the initiative, we plan to double the size of the program in 2007 with 20 hospitals statewide. Our ultimate goal is to enroll every healthcare facility in the state.

Wendy Hess is director of infection control at Hackensack University Medical Center, and William Finck is director of network initiatives at Horizon Blue Cross Blue Shield of New Jersey.