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Is I.T. the Key to Preventing Hospital Infections


By Beckie Kelly Schuerenberg, Senior Editor September 2007
Patricia Burns, R.N., has fought hospital-acquired infections at St. Elizabeth Medical Center for more than 30 years. Over time, paperwork has become another powerful enemy.

Burns, the Edgewood, Ky.-based organization's infection control coordinator, and three other part-time employees used to spend three hours a day mining a 65-page lab report to identify patients with HAIs. Then they spent more time searching the hospital's admission/discharge/transfer system to determine where the infected patients were located.

The process caused significant delays in informing caregivers about the procedures they should take to stop infections from spreading, such as moving afflicted patients into isolation.

"We do our best work when we are out talking to nurses and patients. But we were spending way too much time looking at data in our office," Burns says. "It was incredibly time-consuming to get infection data. We knew something had to happen."

In 2004, something did. St. Elizabeth implemented software designed to automate HAI tracking. The technology receives data from the hospital's lab system, from Cerner Corp., Kansas City, Mo., and its ADT system, from McKesson Corp., San Francisco, and uses proprietary algorithms to analyze the information and pinpoint when and where HAIs occurred. It sends daily e-mails to infection control personnel that categorize the infections by type.

"We are probably two or three days ahead of ourselves compared to where we were years ago because of the difference in the time it takes to get the information," she says. "Now we have more time to use the data and think about things we couldn't have before." Instead of focusing on data collection, they now concentrate on developing strategies to reduce specific types of infections and to work with individual departments to reduce HAIs.

Hospital-acquired infections, also called nosocomial infections, encompass any type of infection patients acquire during a hospital stay. While some can be spread by airborne germs or germs from caregivers' hands, others occur from bacteria that entered a patient's body during or after a clinical procedure.

A massive 2000 study by the Atlanta-based Centers for Disease Control and Prevention estimated that one in 20 patients, about 2 million a year, develop an HAI, with 90,000 of those resulting in death.

HAIs also prolong lengths of stay for patients, and they result in additional surgeries or other treatments that cost hospitals an extra $5,018 per infected patient, according to a March survey by the Washington-based Association for Professionals in Infection Control and Epidemiology. The 77 hospitals in the study reported a combined $286 million net margin reduction as a result. The survey also found that the average additional incremental direct cost for a patient with an HAI is $8,832.

Such surveys, however, reflect only findings from hospitals voluntarily reporting HAIs; there is no federal requirement for acquired infection reporting. Further, most hospitals don't have the resources to track HAIs enterprisewide, so they concentrate their surveillance efforts on a few departments or types of infections.

Changing Perception

But a recent increase in public awareness of HAIs is changing all that. So far, 16 states have passed legislation requiring some type of public HAI reporting. These laws, combined with other local and national patient safety efforts, are driving many health care organizations to step up their HAI monitoring.

"The expectation about reporting and reducing HAIs is part of a larger national trend of quality improvement," says Bob Williams, M.D., a director at New York-based Deloitte Consulting. "But collective data reporting isn't easy to do."

Some hospitals have implemented I.T. to only track the HAIs they are required by state law to do. Other provider organizations, however, are taking a more enterprisewide strategy and using various technologies to track and analyze the entire spectrum of HAIs.

"There are tools to accelerate and facilitate the process of building a database that can be analyzed to identify and track hospital-acquired infections," Williams says. "But there's a lot of variation, and no one tool is more effective across the board than others."

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