Illinois Healthcare-Associated Infections (HAI) Plan

1. Illinois Healthcare-Associated Infections (HAI) Plan Mary Fornek January 21, 2010 Metropolitan Chicago Healthcare Council

3. American Recovery and Reinvestment Act of 2009(ARRA)

4. Four Components of the HAI Plan • HAI Program Infrastructure • Surveillance, Detection, Reporting and Response • Prevention • Evaluation, Oversight, and Communication

5. HAI Program Infrastructure

6. 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)

7. Surveillance, Detection, Reporting and Response

8. 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.

9. 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.

10. 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.

11. 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

12. Surgical Site Infections (SSIs) • Statewide Reporting will be required in APRIL 2010 • 2 Procedures • Total Knee Arthroplasty (TKA) • Coronary Artery Bypass Graft (CABG)

13. 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

14. NHSN SSI Denominator Data

15. 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

16. 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.

17. Prevention

18. 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

19. 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

20. 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

21. Evaluation and Communication

22. 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

24. Questions