chain collaborative healthcare-associated infection (hai) network september 7, 2012

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CHAIN Collaborative Healthcare- associated Infection (HAI) Network September 7, 2012

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Page 1: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

CHAIN Collaborative Healthcare-associatedInfection (HAI) Network

September 7, 2012

Page 2: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

Objective

• Describe the Collaborative for HAI network (CHAIN) goals and how the 10th scope of work, hospital engagement network, MN HAI advisory committee fits in with these goals to provide an overall plan for reducing HAIs in Minnesota.

Page 3: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

HAI Advisory Group Minnesota Statewide HAI Plan

CUSP

Culture

Environmental Cleaning

Antimicrobial StewardshipHand Hygiene Transmission

PrecautionsInjection Practices

CLABSI- Central Line-associated Blood Stream InfectionsCAUTI- Catheter-associated Urinary Tract Infections

SSI- Surgical Site InfectionsCDI- Clostridium Difficile

VAP- Ventilator Associated PneumoniaMRSA- Methicillin-resistant Staphylococcus Aureus

CRE- Carbapenem-resistant Enterobacteriaceae

Other groups•TCAB•MAPS•Reportable events•Meaningful Use•Quality reporting & Improvement

Collaborative Healthcare-Associated Infection (HAI) Network

Hospital LTAC ASCCHAIN

Nursing Home AmbulatoryCHAIN CHAIN CHAIN CHAIN CHAINCHAIN

Home Care HDC

Page 4: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

CHAIN

CHAIN Partners

Page 5: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

CHAIN Partnership Panel

Jane Harper, MDHLinell Santella, APIC-MN

Julie Apold, MHAVicki Tang Olson, Stratis Health

Page 6: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

MDH American Recovery and Reinvestment Act (ARRA) Funding for HAI Prevention 9/2009 – 12/2011

Page 7: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

Ongoing MDH AR / HAI Prevention Unit Activities

• Outbreak investigation and consultation – Endoscope reprocessing – Product recalls – Unusual clusters

• Emerging pathogen surveillance – Invasive MRSA, Carbapenem-resistant Enterobacteriaceae

(CRE), CDI, Influenza– Studies in collaboration with CDC

• Infection prevention and control recommendations to address emerging pathogens/infections or situations– MRSA, CRE (acute care and long term care), H1N1, etc.

Page 8: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

Ongoing MDH AR / HAI Prevention Unit Activities (cont’d.)

• Antimicrobial Stewardship – Guide for Comprehensive Antimicrobial Stewardship Programs

• www.health.state.mn.us/divs/idepc/dtopics/antibioticresistance/index.html

– Kick-off September 27, 2012– Key audience: physicians and pharmacists

• Coordination with other MDH Sections /Divisions – Facility Provider Compliance – Health Policy and Health Reform– Immunization Program

Page 9: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

CHAIN is an effort lead by the Association for Professionals in Infection Control and Epidemiology-Minnesota (APIC), Minnesota Department of Health, Minnesota Hospital Association, and Stratis Health.

• NHSN User Group • Participate with Stratis Health and APIC-MN

• Content and surveillance expertise (infectious diseases, infection prevention and control)

• Possible future collaborative activities with MHA / Stratis Health / APIC-MN

MDH AR/HAI Prevention Unit Role with CHAIN

Page 10: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

APIC MN

• As chapter president in 2011, invited to participate on CHAIN Steering Committee

• APIC strategic plan: network with other organizations

• The Fit:– Subject: HAI collaboration across MN– Could it fit any better?– And who better to join forces with―Stratis

Health, MHA, MDH

Page 11: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

APIC MN• After all, what is our work?

– Combating HAIs in our facilities• Researching evidence-based practices• Developing strategies• Educating our staff and patients• Monitoring for compliance• Measuring outcomes• Reporting outcomes to the state…to NHSN• Doing what we can to keep our facilities solvent--

reducing infections, CMS reporting for reimbursement

Page 12: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

APIC MN• With CHAIN we will now have

– Support from other community leaders– A format to share tools, ideas, expertise

• My role with CHAIN– To represent APIC MN Infection Preventionists to the

best of my ability– To share with CHAIN what we do, how we do it, and

what we need– To share the work at APIC MN meetings and seek

input from infection preventionists

Page 13: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

CMS Partnerships for Patients• National public/private partnership to

improve the quality, safety and affordability of healthcare

• Center for Medicare and Medicaid Innovation (CMMI) allocated $1 billion in funding for Partnerships for Patients Initiatives

• Goals by the end of 2013:– Decrease preventable hospital-acquired conditions by 40%– Decrease preventable hospital readmissions by 20%

Page 14: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

Hospital-Acquired Conditions• 10 Hospital-acquired conditions

– Pressure ulcers– Falls– Adverse drug events– Obstetrical adverse events– Catheter associated urinary tract infection (CAUTI)– Surgical site infection (SSI)– Central line associated blood stream infection (CLABSI)– Ventilator-associated pneumonia (VAP)– Venous thromboembolism (VTE)– Readmissions

• 2 Additional topics– Culture– TCAB

Page 15: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

Partnership for Patients

HAI

AHRQ

OAT

Page 16: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

How does it fit together?

Accountable Care ActAccountable Care Act

Center for Medicare & MedicaidCenter for Medicare & Medicaid

Page 17: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

Medicare QIO Promgram

Page 18: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

Other focus areas• Rural Health • Health Disparities• HIT

Page 19: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

CAUTI/SSI initiative

• 12 Hospitals

• Monthly Reporting to NHSN

• CUSP Training

• Gap Analysis and Action Plan

• Group Calls – Best Practices

Page 20: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

CDI/SSI

• 12 Hospitals recruited• May 2012 – July 2014• Begin first with monthly entry into NHSN• MDH is developing antimicrobial stewardship

roadmap for release in fall• Improvement cycles begin January 2013

Page 21: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

MDH Antimicrobial Stewardship Program Survey

CAH(n= 37)

PPS(n=28)

Total

Yes 10 (27%) 18 (64%) 28

No 27 (73%) 10 (36%) 37

Does your hospital have an antimicrobial stewardship program in place?

Page 22: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

CAUTI SSI CDI

Relationship between Roadmap and Initiatives

Page 23: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

CHAIN Activities

Page 24: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

HAI Advisory

Initiatives EducationCommunication

Roadmaps

SSI CDI CAUTI VAP

HAI SAFE

CLABSI MDRO

Environmental Cleaning Hand hygiene Antimicrobial

stewardshipTransmission Precautions

Injection Practices

Chain Branding

Website

Listserv

Measurement

NHSN Outcome Measures

MN infection

SAFE from HAI Roadmap Process

Measures

SAFE from HAI

CAUTI

CDI

SSI

SSI

Group Calls

Webinars

Action Days

1:1 Support

Page 25: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012
Page 26: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

MN HAI Infrastructure• MDH HAI Advisory Group

– Oversee Overall Minnesota HAI Plan

• CHAIN– Support Minnesota HAI plan – Support SAFE from HAI– Identify infection prevention gaps and opportunities– Provide input and direction on implementation needs

and reporting efforts across the state– Provide education and resources

Page 27: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

CHAIN Operations Group

• Work together in partnership to provide seamless support to Minnesota Hospitals

• Coordinate implementation efforts between partnering organizations to maximize resources

• Identify funding sources as needs are identified• Evaluate success of interventions and impact on

outcomes

Page 28: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

Consumer Feedback• Stratis Health Consumer Group• May 2012• Alcohol-based Disinfection• Handwashing

Page 29: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

MN NHSN Users Group

• Purpose: support infection preventionists with NHSN definitions, entry, and reporting

• Standard agenda – 1st Thursday, 1-2p.m.– Updates from MDH/CDC– Updates from Stratis Health– Best practices sharing– Case studies/Troubleshooting/Networking

• APIC joining as co-leader• Join NHSN/HAI distribution list for agenda/minutes

Page 30: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

CHAIN Websitewww.MNreducinghai.org

Organized according to roadmap SAFE Building blocks/Prevention Strategies Targeted Infections

Page 31: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

HAI Roadmap

SAFE = common across infection topics• S = SAFE from HAI teams• A = Accurate and concurrent reporting• F = Facility expectations• E = Education for patients and families

Page 32: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

Safe from HAI Roadmap

• Building Blocks/Core Prevention- Handwashing- Antimicrobial Stewardship- Instituting environmental cleaning- Injection Practices- Transmission Precautions

Page 33: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

Clinical BundlesClinical Bundles• CLABSI• CAUTI• CDI• SSI• VAP

Page 34: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

What is on the Horizon?• Support SAFE from HAI

– Webinars• Quarterly CHAIN webinars; additional on-going opportunities

– In-person action days– Listserv– On-going advisory group review of data; identify and

address gaps– Development of tools/resources as needed

• Continued support from NHSN Users Group• Continued coordination of infection reporting• Continued coordination and support for all Minnesota

Infection Prevention activities

Page 35: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

How do I get involved?• Share tools/resources with colleagues via listserv or

posting on CHAIN website• Participate in educational opportunities• Access website resources: www.MNreducingHAIs.org• Sign up for Safe from HAI: [email protected]• Sign up for listserv: [email protected] • Sign up for NHSN/HAI distribution list: [email protected]• Sign up for CAUTI and/or CDI initiative for targeted

support: [email protected]

Page 36: CHAIN  Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012

Key ContactsCHAIN, or CAUTI/SSI/CDI-specific support

Bruce Johnson, Program Manager, Stratis [email protected]

SAFE from HAIMickey Reid, Manager, Patient Safety/Quality, Minnesota Hospital [email protected]

Statewide HAI PlanJean Rainbow, Nurse Specialist, Minnesota Department of [email protected]