Reduction in Health Care Facility-Onset Infection: A Quality Improvement Initiative.

OBJECTIVE

To reduce health care facility-onset (HCFO) infection (CDI) incidence by improving diagnostic stewardship and reducing the inappropriate testing of assays.

PATIENTS AND METHODS

A multidisciplinary team conducted a quality improvement initiative from January 1, 2020, through March 31, 2021. infection and inappropriate testing were identified via electronic health records using predefined criteria related to stool quantity/caliber, confounding medications, and laboratory data. An intervention bundle was designed including (1) provider education, (2) implementation of an appropriate testing algorithm, (3) expert review of orders, and (4) batch testing of assays to facilitate review and cancellation if inappropriate.

RESULTS

Compared with a baseline period from January to September 2020, implementation of our intervention bundle from December 2020 to March 2021 resulted in an 83.6% reduction in inappropriate orders tested and a 41.7% reduction in HCFO CDI incidence.

CONCLUSION

A novel prevention bundle improved diagnostic stewardship and HCFO CDI incidence by reducing testing of inappropriate orders. Such initiatives targeting HCFO CDI may positively affect patient safety and hospital reimbursement.