Spreading HAI Reduction Initiatives through State Health Department and Quality Improvement Organization Collaboration

Background: Healthcare-associated infections (HAIs) cause significant morbidity and mortality and cost the U.S. healthcare system $5.7 to $6.8 billion annually.  The U.S. Department of Health and Human Services classifies HAI reduction as a Priority Goal, and the Centers for Disease Control and Prevention identifies HAI elimination as a Winnable Battle.  In Illinois, two agencies, the Illinois Department of Public Health (IDPH) and the Medicare Quality Improvement Organization (QIO), Telligen, have maximized infection prevention efforts through close collaboration.

Program background: Since 2009, IDPH and Telligen have partnered to plan and implement targeted initiatives to improve the ability of approximately 200 hospitals and 800 long term care facilities (LTCFs) to prevent HAIs. The Agencies recommend the same best practices and employ an interactive “all teach all learn” approach such that diverse providers have a platform to share with each other.  Our multi-modal health communication strategy involves engaging small numbers of healthcare facilities in learning and action groups called prevention collaboratives and spreading best practices and lessons learned through statewide educational programs.   We implemented a Clostridium difficile infection (CDI) prevention collaborative with 20 hospitals beginning in 2010 that reduced CDI incidence in the group of facilities by 15%.  Strategies employed by the collaborative were disseminated in a 2012 statewide campaign that required facilities’ leadership to pledge commitment to CDI prevention and support staff attendance at monthly webinars and regional in-person workshops. To combat antibiotic resistance, IDPH and Telligen co-hosted a statewide summit in 2013 bringing together diverse healthcare professionals to discuss strategies for improving the use of antibiotics and showcasing experiences of hospitals involved in IDPH’s antimicrobial stewardship collaborative the preceding year.  IDPH and Telligen utilize diverse partnerships to “get the word out” to healthcare facilities through emails, newsletters, fax, and listserv mailings.  Our marketing benefits from the unique strengths of each organization:  Telligen has a more established relationship with LTCFs and their trade organizations while IDPH has developed a stronger bond with hospitals based on mandated reporting of HAIs.

Evaluation Methods and Results: Facility participation is tracked.  Pre/post- surveys are administered to assess facility implementation of infection prevention practices.  The IDPH-Telligen collaboration has resulted in strong engagement of healthcare facilities.  More than 250 hospitals and LTCFs participated in the CDI prevention campaign and 119 reported implementing a prevention activity as a result of the campaign; 250 individuals attended the antimicrobial stewardship summit.  Program evaluations have consistently ranged from 4-5/5.   Healthcare providers report appreciation for the coordination of activities, consistency in messaging, and opportunities to share with and learn from peers. 

Conclusions:  IDPH and Telligen have supported a unified voice for infection prevention and patient safety across the spectrum of Illinois healthcare facilities.  Coordinated efforts allow us to implement initiatives, reach a diverse audience and meet our respective agency HAI deliverables.

Implications for research and/or practice: Effective partnerships bolster credibility and leverage resources and expertise needed to disseminate best practices and engage healthcare communities.  Health departments and QIOs can extend the reach of their HAI prevention work and attract continued funding by exploring opportunities to harmonize efforts and messaging.