title: Multihospital infection prevention collaborative: informatics challenges and strategies to prevent MRSA.
abstract: We formed a collaborative to spread effective MRSA prevention strategies. We conducted a two-phase, multisite, quasi-experimental study of seven hospital systems (11 hospitals) in IN, MT, ME and Ontario, Canada over six years. Patients with prior MRSA were identified at admission using regional health information exchange data. We developed a system to return an alert message indicating a prior history of MRSA, directed to infection preventionists and admissions. Alerts indicated the prior anatomic site, and the originating institution. The combined approach of training and coaching, implementation of MRSA registries, notifying hospitals on admission of previously infected or colonized patients, and change strategies was effective in reducing MRSA infections over 80%. Further research and development of electronic surveillance tools is needed to better integrate the varied data source and support preventing MRSA infections. Our study supports the importance of hospitals collaborating to share data and implement effective strategies to prevent MRSA.
authors.affiliation: VA HSR&D Center, Roudebush VAMC, Indianapolis, IN; ; Regenstrief Institute, Indianapolis, IN; ; Indiana University School of Medicine, Indianapolis, IN;
authors.forename: Bradley N
authors.initials: BN
authors.lastname: Doebbeling
authors.affiliation: Indiana University School of Medicine, Indianapolis, IN;
authors.forename: Mindy E
authors.initials: ME
authors.lastname: Flanagan
authors.affiliation: Regenstrief Institute, Indianapolis, IN;
authors.forename: Glenna
authors.initials: G
authors.lastname: Nall
authors.affiliation: Regenstrief Institute, Indianapolis, IN;
authors.forename: Shawn
authors.initials: S
authors.lastname: Hoke
authors.affiliation: Regenstrief Institute, Indianapolis, IN; ; Indiana University School of Medicine, Indianapolis, IN;
authors.forename: Marc
authors.initials: M
authors.lastname: Rosenman
authors.affiliation: Regenstrief Institute, Indianapolis, IN; ; Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Abel
authors.initials: A
authors.lastname: Kho
mesh_terms: D002170:Canada; D003299:Cooperative Behavior; D003428:Cross Infection / Q000517:prevention & control*; D006739:Hospital Administration; D006751:Hospital Information Systems; D006801:Humans; D017053:Infection Control / Q000379:methods / Q000458:organization & administration*; D033181:Information Dissemination; D055624:Methicillin-Resistant Staphylococcus aureus; D013203:Staphylococcal Infections / Q000517:prevention & control*; D014481:United States