Clostridium difficile (C.diff) is a potentially life-threatening bacterium that most commonly affects older adults, and individuals without a history of antibiotic use. The majority ofC.diff infections occur in, or after exposure to, healthcare settings and they are becoming more frequent, severe, and difficult to treat. In 2016, Mount Sinai Health System made reducing hospital-onset C.diff infection (HO-CDI), across all their sites, a top priority.
Leadership and infection prevention staff—using system-wide and local expertise, data-driven decision making, frequent audits, and feedback—implemented a four-pronged approach to fight infection. Interventions, including diagnostic stewardship, enhanced environmental cleaning, antibiotic stewardship, and a hand hygiene campaign, were implemented throughout their hospitals. Local leadership determined site-specific execution, accommodating each hospital’s unique operating procedures. HO-CDI rates are shared among the hospitals via a quality dashboard.
Between 2013 and 2016, these efforts reduced HO-CDI from 7.23 per 10,000 patient-days to 4.13 per 10,000 patient-days, a 43% reduction. Additionally, each hospital decreased its HO-CDI-rate by between 32% and 79%. Hand hygiene compliance also improved from 63% in 2015 to 81% in 2016.
For more information, contact Vicki Lopachin, M.D., M.B.A., Chief Medical Officer, The Mount Sinai Hospital, (212) 659-9072, firstname.lastname@example.org.