2014 Midas+ Symposium – May 19-21 – Tucson, AZ 1

Infection Control –The Power of Integration

Stacy Norris, RN, BSNMidas+ Clinical Product Manager

Infection PreventionOver the last several years, regulatory demands, both state and federal, have increased exponentially.The data mining, analysis, and reporting requirements have resulted in a laborious undertaking by the Infection Preventionists.This session will provide an overview of the Midas+ Infection Control Module and Clinical Integration and how together they provide a powerful tool to track, trend, and mine data. We will review the Midas+ NHSN SSI and Device-MDRO and Cdiff Toolkits.Finally we will review reporting capabilities within Midas+, as well as within the DataVision and Statit solutions.

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 2

Key Terms• HAI (Hospital Acquired Infection)• NHSN (National Health Safety Network)• SSI (Surgical Site Infection)• MDRO (Multi-Drug Resistant Organism)• CDC (Centers for Disease Control)• AHRQ (Association for Healthcare Research & Quality)• PSI (Patient Safety Indicators)• VBP (Value-Based Purchasing)• HCAHPS (Hospital Consumer Assessment of Healthcare

Providers and Systems)

State of Infection Control Reporting

• Increased reporting requirements, both federal and state

• Increased commercial payer data demands

• Pending legislation at state and national levels inclusive of infection prevention

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 3

AHRQPrevention

TJCVBP

HCAHPS

Surgical Complications

HACsNHSN - HAI Measures

CleanlinessOverall

Satisfaction

Mort 30 PN

Patient Experience

AHRQ PSI 90

Immunization for Flu

CLABSI

CAUTI

C.diff MRSA Bacteremia

HCP Influenza Vaccination

CAUTI

Universal Protocol

CAUTI

IC & EP Standards

Isolation Practices

Sentinel Events

Immunization Immunization for

Pneumonia

SSISSI -

Orthopedic

SSI - CABG

Vascular Catheter-Assoc. Infection SSI-Bariatric

Surgery

SSI - CIED

Vascular CathVascular CathAssoc

InfectionPSI 90

HIHI

AKAK FLFL

MIMI

MEME

NYNY

PAPA

VAVAWVWV

OHOHININILIL

WIWI

NCNCTNTN

AKAK

MOMO

GAGASCSC

KYKY

ALAL

LALA

MSMS

IAIA

MNMN

OKOK

TXTX

NMNM

KSKS

NENE

SDSD

NDND

WYWY

MTMT

COCO

IDID

UTUT

AZAZ

NVNV

OROR

WAWA

CACA

HI

AK FL

MI

ME

NY

PA

VAWV

OHINIL

WI

NCTN

AK

MO

GASC

KY

AL

LA

MS

IA

MN

OK

TX

NM

KS

NE

SD

ND

WY

MT

CO

ID

UT

AZ

NV

OR

WA

CA

State Reporting Laws

Pending Legislation

Voluntary or Study programs in place

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 4

Infection Preventionists defined:• Defined in 2008 by APIC to clearly

define what the profession does

• Infection Preventionists direct interventions that protect patients from healthcare-associated infections (HAIs) in clinical and other settings around the world. They work with clinicians and administrators to improve patient and systems-level outcomes and reduce HAIs and related adverse events.

Infection Prevention:

• Education to Staff and Patients

• Application of Prevention and Control Measures

• Regulatory Compliance Monitoring and Assurance

• Surveillance

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 5

Surveillance Cycle

Evaluate Population

Evaluate population served and determine areas of risk for adverse outcome and process

Back to main

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 6

Determine Methodology

Determine the methodology for investigation and monitoring.How will you identify those patients or special conditions/circumstances as part of surveillance

Back to main

Mine Data

Mine/Gather the data associated with surveillance activities

Back to main

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 7

Analyze Data

Analyze it for variation, trends and significance patterns

Back to main

Report Meaningfully

Report in meaningful and actionable format

Back to main

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 8

Evaluate Population

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 9

Ease of data entry

Interface capabilities

Reporting powerhouse

Extensive data compilation

Integration with other Midas+ Solutions further enhancing the

capabilities

User customizable information warehouse that the Infection Preventionist can mine data from

as needed and cyclically to evaluate the population served

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 10

Determine Methodology

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 11

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 12

Easy as 1, 2 & 3

Midas+ Interface Capabilities:

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 13

Midas+ Infection Control and Clinical IntegrationClinical Information Interfacing that includes:

– Surgery Information– General Lab– Microbiology– Blood Bank– Pharmacy

Microbiology Data• Ordering Physician• Diagnostic Test• Culture Source• Culture Site• Date/Time of Culture Collection• Method of Study• Organism Result• Drug-associated Sensitivies & MIC

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 14

General Lab Data• Hematology

– CBC– Coag Studies

• Chemistry– Drug Levels– Glucose Monitoring

• Serology• Disease Specific Reporting

– C.diff, HIV, Influenza, Rapid Strep et al…

Pharmacy Data

• ADEs• Dosing Frequency• Resistant Drug Monitoring• Antimicrobial Stewardship

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 15

Surgery Data• Date of Surgery• Surgeon• Surgical Specialty• Anesthesiologist• Anesthesia type• Patient Status• OR room• Surgical Class• Diagnosis• Anesthesia Risk

• Anesthesia Start Time• Anesthesia End time • Surgery Start Time• Surgery End Time• Patient In Time• Patient Out Time• Procedures• Surgical Team

Go from this… …to this!

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 16

Clinical Integration in Action

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 17

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 18

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 19

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 20

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 21

NHSN ToolkitsSSI, Device and MDRO

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 22

NHSN Toolkits:SSI, Device and MDRO• Event tracking simplified and efficient data

collection• Automated denominator mining and data

compilation• Standard report generates logs to identify

cases that qualified for submission as well as those missing key criterion required

• Extraction utility creates compressed files for easy upload to NHSN

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 23

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 24

Reporting

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 25

Mine Data

Types of Reporting

• Smart Track– Record selection using any combination of data fields– Profile reports containing counts, rates, and sums of selected data.– Efficiently and effectively manage workflow– Automated Critical Event Alerts through worklist creation– Patient tracking capabilities

• Report Track– Line listings of selected data elements– Worksheet creation– Template letters for Document Generation

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 26

Smart Track examples: • Percent of central line associated primary bloodstream infections

per 1000 central line days by unit• Rate of post-operative sepsis per 1000 elective surgical

discharges• Incidence of bacterial pneumonia• Rate of hospital acquired urinary tract infections• Percent of patients with documented infection placed in

appropriate isolation precautions • Incidence of ventilator associated pneumonia by unit• Rate of C.Diff positive cultures by unit• MDRO worklist notification for IP surveillance• Customized focused surveillance notifications to IP based on

culture source, organism, location etc…

Report Track examples:• Line listing of patient for state reportable illnesses• Post Discharge surveillance cases for select

procedures• TB Patient listing• Line listing of community acquired infections with

key select data elements

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 27

Analyze Data

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 28

Basic Infection Control Data Profile…

With additional data entry and/or Clinical Integration:

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 29

Report Meaningfully

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 30

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 31

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 32

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 33

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 34

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 35

Midas+ Statit

Statit• Performance Indicator and Management

System

• Assists with monitoring of organizational performance over time at a hospital, departmental, and team level

• Accepts various data sources such as Microsoft Excel, ODBC-compliant databases and other Midas+ System components

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 36

Statit Example

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 37

Midas+ Datavision

Datavision• Utilizes data from the Midas+ comparative

database– Several hundred hospitals with comparative

data

• Parameter selection allows for control of date and facility characteristics

• Organizational data locally or comparison data via web application

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 38

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 39

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 40

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 41

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 42

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 43

User customizable information warehouse that the Infection Preventionist can mine data from

as needed and cyclically to evaluate the population served

2014 Midas+ Symposium – May 19-21 – Tucson, AZ 44

Thanks for attending. Are there any questions?

Stacy Norris BSN RN, Midas+ Clinical Product Managerstacy.norris@xerox.com