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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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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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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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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: