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Evaluation of GeoHAI Implementation

Not Applicable
Recruiting
Conditions
Clostridioides Difficile Infection
Healthcare Associated Infection
Interventions
Other: GeoHAI
Registration Number
NCT05612672
Lead Sponsor
Ohio State University
Brief Summary

Geographic Information Systems (GIS) and spatial analysis have become important tools in public health informatics but have rarely been applied to the hospital setting. In this study we apply these tools to address the challenge of Hospital Acquired Infections (HAIs) by building, implementing, and evaluating a new computer application which incorporates mapping and geographic data to assist hospital epidemiologists in identifying HAI clusters and assessing transmission risk. We expect that incorporation of geographic information into the workflow of hospital epidemiologists will have a profound effect on our understanding of disease transmission and HAI risk factors in the hospital setting, radically altering the workflow and speed of response of infection preventionists and improving their ability to prevent HAIs.

Detailed Description

Hospital Acquired Infections are common, affecting 3.2% of acute care hospital admissions. Recent reports have shown an improvement in overall HAI rates, primarily driven by improvements in surgical site (SSI) and catheter associated urinary tract infections (CAUTI). Transmissible infections, such as Clostridium difficile (CDI), have not shown the same decrease over time. This may be because prevention of CDI requires a comprehensive hospital-wide approach addressing environmental and patient-level risk factors. Geographic Information Systems (GIS) and spatial analysis techniques have become an important tool in public health informatics because they can integrate a vast number of data sources and explore associations and patterns in the data not visible using traditional biostatistical methods. Applications of GIS and spatial analysis are wide ranging but have largely been ignored in the hospital setting. The objective of this research is to develop a HAI assessment tool, which incorporates geographic data on the hospital and patient-level data from the electronic health record system, that is useful for hospital infection preventionists in better identifying clusters of HAI and assessing potential risk. We bring together a multidisciplinary team of clinical, operational, and academic investigators with expertise in GIS and spatial analysis, patient safety, public health informatics, usability assessment, and mixed- methods evaluation. As part of a larger study, this aim will seek to implement a GeoHAI tool that uses spatio-temporal Bayesian models to identify clusters of NHSN-defined hospital onset CDI and multidrug resistant organisms (MDRO) and predict potential high risk areas given hospital and patient risk factors. Unique to our approach is an evaluation strategy that focuses on the reduction of hospital acquired infection, but also seeks to understand how the tool and the information derived from the tool impacts patient safety practices in the hospital. We expect the implementation of this tool to radically change the workflow and speed of response of infection preventionists, greatly improving their ability to prevent HAI instead of reacting after they have occurred.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
25
Inclusion Criteria
  • Infection preventionist or physician involved in infection prevention at participating health system
Exclusion Criteria
  • Not an infection preventionist nor a physician involved in infection prevention
  • Does not work at the participating health system

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
GeoHAI UseGeoHAIParticipants will use the GeoHAI tool
Primary Outcome Measures
NameTimeMethod
Change from Baseline Healthcare-Associated Infection (HAI) Rate6 months

HAI rate at healthcare system level before intervention and after

Secondary Outcome Measures
NameTimeMethod
Feasibility score6 months

Score on feasibility, acceptability, and appropriateness domains of validated Implementation Outcome scale (minimum score = 1, maximum score = 5, where higher scores indicate better feasibility)

Knowledge of toolImmediately post-training

Knowledge questions to assess understanding of how to use the GeoHAI tool, assessed after participants are trained on how to use the tool

Change from baseline skill confidence at one year6 months

Self-reported level of confidence on investigating HAI clusters

Usability score6 months

System Usability Scale score, and impacts of the tool on work and workflow (interruptions, workarounds, issues/challenges)

GeoHAI Use6 months

Self-reported frequency of use of the GeoHAI tool

Change in Healthcare-Associated Infection (HAI) Investigation Process6 months

Change in how infection preventionists investigate Healthcare-Associated Infections (HAIs)

Number of months healthcare system is below goal HAI rate6 months

Monthly HAI rate at healthcare system level before intervention and after

Time to HAI cluster identification6 months

Time from when an HAI test was ordered for the first positive patient ultimately contained in an identified HAI cluster, to when that HAI cluster is identified.

Trial Locations

Locations (1)

The Ohio State University

🇺🇸

Columbus, Ohio, United States

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