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CHAIN Collaborative Healthcare-associated Infection (HAI) Network September 7, 2012. Objective. - PowerPoint PPT Presentation
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CHAIN Collaborative Healthcare-associatedInfection (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.
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
CHAIN
CHAIN Partners
CHAIN Partnership Panel
Jane Harper, MDHLinell Santella, APIC-MN
Julie Apold, MHAVicki Tang Olson, Stratis Health
MDH American Recovery and Reinvestment Act (ARRA) Funding for HAI Prevention 9/2009 – 12/2011
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.
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
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
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
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
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
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%
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
Partnership for Patients
HAI
AHRQ
OAT
How does it fit together?
Accountable Care ActAccountable Care Act
Center for Medicare & MedicaidCenter for Medicare & Medicaid
Medicare QIO Promgram
Other focus areas• Rural Health • Health Disparities• HIT
CAUTI/SSI initiative
• 12 Hospitals
• Monthly Reporting to NHSN
• CUSP Training
• Gap Analysis and Action Plan
• Group Calls – Best Practices
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
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?
CAUTI SSI CDI
Relationship between Roadmap and Initiatives
CHAIN Activities
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
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
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
Consumer Feedback• Stratis Health Consumer Group• May 2012• Alcohol-based Disinfection• Handwashing
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
CHAIN Websitewww.MNreducinghai.org
Organized according to roadmap SAFE Building blocks/Prevention Strategies Targeted Infections
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
Safe from HAI Roadmap
• Building Blocks/Core Prevention- Handwashing- Antimicrobial Stewardship- Instituting environmental cleaning- Injection Practices- Transmission Precautions
Clinical BundlesClinical Bundles• CLABSI• CAUTI• CDI• SSI• VAP
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
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]
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]