Journal article
Development and implementation of a nationwide multidrug-resistant organism tracking and alert system for Veterans Affairs medical centers
Infection control and hospital epidemiology, Vol.45(9), pp.1073-1078
09/2024
DOI: 10.1017/ice.2024.79
PMCID: PMC11518666
PMID: 38785174
Abstract
Develop and implement a system in the Veterans Health Administration (VA) to alert local medical center personnel in real time when an acute- or long-term care patient/resident is admitted to their facility with a history of colonization or infection with a multidrug-resistant organism (MDRO) previously identified at any VA facility across the nation.
An algorithm was developed to extract clinical microbiology and local facility census data from the VA Corporate Data Warehouse initially targeting carbapenem-resistant
(CRE) and methicillin-resistant
(MRSA). The algorithm was validated with chart review of CRE cases from 2010-2018, trialed and refined in 24 VA healthcare systems over two years, expanded to other MDROs and implemented nationwide on 4/2022 as "VA Bug Alert" (VABA). Use through 8/2023 was assessed.
VABA performed well for CRE with recall of 96.3%, precision of 99.8%, and F1 score of 98.0%. At the 24 trial sites, feedback was recorded for 1,011 admissions with a history of CRE (130), MRSA (814), or both (67). Among Infection Preventionists and MDRO Prevention Coordinators, 338 (33%) reported being previously unaware of the information, and of these, 271 (80%) reported they would not have otherwise known this information. By fourteen months after nationwide implementation, 113/130 (87%) VA healthcare systems had at least one VABA subscriber.
A national system for alerting facilities in real-time of patients admitted with an MDRO history was successfully developed and implemented in VA. Next steps include understanding facilitators and barriers to use and coordination with non-VA facilities nationwide.
Details
- Title: Subtitle
- Development and implementation of a nationwide multidrug-resistant organism tracking and alert system for Veterans Affairs medical centers
- Creators
- Christopher D Pfeiffer - VA Portland Health Care SystemMakoto M Jones - University of UtahJames S Klutts - United States Department of Veterans AffairsQuinn A Francis - VA Portland Health Care SystemHannah M Flegal - VA Portland Health Care SystemAdrienne O Murray - VA Salt Lake City Healthcare SystemTina M Willson - University of UtahNatalie R Hicks - United States Department of Veterans AffairsCharlesnika T Evans - Northwestern UniversityMartin E Evans - University of Kentucky
- Resource Type
- Journal article
- Publication Details
- Infection control and hospital epidemiology, Vol.45(9), pp.1073-1078
- DOI
- 10.1017/ice.2024.79
- PMID
- 38785174
- PMCID
- PMC11518666
- NLM abbreviation
- Infect Control Hosp Epidemiol
- eISSN
- 1559-6834
- Language
- English
- Electronic publication date
- 05/24/2024
- Date published
- 09/2024
- Academic Unit
- Pathology
- Record Identifier
- 9984630598202771
Metrics
10 Record Views