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Developing a dynamic, integrated, web-based antibiotic resistant organism

surveillance system for Fraser Health

Quality Forum 2017: Imagine Tomorrow, Act Today

Vladlena Abed, Infection Prevention and Control (IPC) Practitioner

Louis Wong, Epidemiologist

Tara Leigh Donovan, Managing Consultant, IPC Clinical

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Disclosures

The presenters have nothing to disclose.

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Objectives

To describe the process of developing Fraser Health’s MRSA and VRE surveillance system;

To describe the successes and challenges in developing the surveillance system

This presentation DOES NOT cover the technical

programming of the surveillance system.

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What are MRSA and VRE?

Vancomycin-Resistant Enterococcus (VRE)

Methicillin-Resistant Staphylococcus Aureus (MRSA)

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Healthcare-Associated Infections (HAI) Surveillance in Acute Care

All lab-positive MRSA and VRE results are reviewed by IPC practitioners using a standardized surveillance protocol, which aligns with the provincial protocol

MRSA and VRE are not reportable diseases in BC

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Surveillance Objectives for MRSA and VRE

Objectives of MRSA and VRE surveillance in Fraser Health acute care facilities are:

To describe the contribution of MRSA and VRE to the overall incidence of HAI among admitted patients in Fraser Health acute care facilities;

To determine the rates and trends of MRSA and VRE in Fraser Health acute care facilities in order to implement and evaluate preventative measures to reduce MRSA and VRE and improve patient outcomes

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From Microsoft Access to iTracker

Project team reviewed existing internal (e.g., Microsoft Access) and external platforms

Considered: financial resources, human resources for ongoing maintenance, and integration with existing platforms (e.g., Meditech)

Decision to embark on building a comprehensive, complex surveillance system (first of its kind in iTracker)

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Before and After

Before

Labour intensive (e.g., manual data entry)

Time consuming

Poor data quality

Technical limitations

Lack of sufficient clinical information

After

Integrated with laboratory data

Allows multiple users to access the database at any given time

Potential for growth

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Timeline

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Balancing Act

Surveillance Case

Management

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Who do you need to engage when you build a surveillance system?

Business Analyst and Software Developer

Epidemiologist

Data Analysts

Infection Prevention and Control Practitioners

Privacy/Ethics

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What do you need to build a surveillance system?

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The common language of patient safety. What does it sound like?

Avoid technical jargon

Have time and place to establish common language

Do not assume

Nothing is as simple as you think

Brainstorming is important and beneficial

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Key Lessons

small BIG. Size and scope matters.

Timelines are evergreen

Sufficient time needs to be spent on understanding system requirements, and

Be comfortable with instead of

Objectives of the surveillance system need to be clearly articulated and defined – balance between case management and surveillance

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Key Lessons (continued)

Integration with different information technology systems remains a challenge

Partnership and engagement with end-users (i.e., IPC practitioners) need to take place early on

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Next Steps

Develop routine MRSA and VRE reports to drive practice change and improve patient outcomes

Develop and implement data validation queries to ensure data quality

Develop and implement routine maintenance and communication processes and protocols

Evaluate the surveillance system

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Acknowledgements

Infection Prevention and Control

Loretta Bogert-O’Brien

Angeli Mitra

Daniel Chan

Dr. Elizabeth Brodkin

Petra Welsh

IPC Consultants and IPC Practitioners

Health and Business Analytics

Ziquan (Steven) Zhou

Robin Suprun

Edmund Pang

Lubin Liou

We would like to acknowledge the support and contributions of the following individuals:

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THANK YOU! QUESTIONS?