The U.S. Department of Health and Human Services (HHS), the Association for Professionals in Infection Control and Epidemiology (APIC), and the Society for Healthcare Epidemiology of America (SHEA) have recognized the University of Vermont Medical Center with the 2014 Partnership in Prevention Award for achieving sustainable improvements toward eliminating healthcare-associated infections (HAIs).
Co-sponsored by HHS, APIC and SHEA, this annual award is based on the concepts of the National Action Plan to Prevent Health Care-Associated Infections: Roadmap to Elimination.
The University of Vermont Medical Center (UVM Medical Center) has created a culture of safety that encourages collaboration across ranks and disciplines, involving C-suite leaders, healthcare providers, caregivers, infection prevention experts, quality improvement experts, environmental services staff, and a team of infection prevention advocates from across the hospital, ambulatory clinics, and dialysis centers. Since 2008, with C-suite support and leadership, they have engaged multidisciplinary teams that focus on infection prevention and control initiatives, significantly reducing central line-associated bloodstream infections (CLABSI), surgical site infections (SSI), and other HAIs in multiple patient populations.
The 562-bed academic medical center in Burlington, Vermont has demonstrated innovative and creative solutions to sustain prevention of HAIs in some of its most vulnerable patient populations. By 2013, UVM Medical Center had achieved a 77 percent reduction in CLABSI in their medical intensive care unit (MICU). In the past 12 months, the MICU CLABSI rate continued to decline—from an 18-month baseline (January 2009 to June 2010) value of 2.72 infections per 1000 central line days to 0.33 infections per 1000 central line days (July 2013 to July 2014). When the neonatal ICU recently experienced two infections following a period of 36 months without a CLABSI, the existing interdisciplinary team quickly mobilized to perform an analysis to understand what occurred so it could be prevented in the future.
Additionally, UVM Medical Center’s culture of safety led to the development of two surgeon-directed initiatives that standardized and reduced variation in practice resulting in a sustained SSI rate reduction. Total knee and hip joint replacement infection rates for the past 12 months are 81 percent lower than the 2009-2010 baseline rate, and orthopedic spinal fusion SSI rates have dropped by 62 percent. For total knee surgery, UVM Medical Center has performed 1677 infection-free procedures since the last infection occurred in November 2010. UVM Medical Center plans to expand this initiative for colon surgical procedures.
In 2009, UVM Medical Center joined the Centers for Disease Control and Prevention (CDC)'s Dialysis Bloodstream Infection Prevention Collaborative to reduce access-related bloodstream infections in six outpatient dialysis centers. Using staff engagement and education to improve adherence to the CDC’s evidence based recommendations the six centers reduced the rate of central line access-related bloodstream infection by 83 percent. In addition the centers have partnered with the CDC to trial and validate revised recommendations for routine disinfection of the dialysis station.
“Successful infection prevention programs, as demonstrated by the 2014 Partnership in Prevention Award recipient, require a multi-faceted approach to infection prevention and control,” says Jennie L. Mayfield, BSN, MPH, CIC, APIC president. “UVM Medical Center addressed HAIs at every level and throughout its care settings, achieving tremendous results. Their organization-wide achievements serve as an excellent model for other facilities seeking to reduce healthcare-associated infections. ”
“HAI elimination relies on hospital-wide participation, and the 2014 Partnership in Prevention Award recipient is a great example of how engaging the entire healthcare team can effectively prevent infections,” says Daniel Diekema, MD, president of the SHEA. “Providing practical tips and tools will help other facilities implement similar quality improvement efforts to provide patients with safer care and improve patient outcomes.”