CHANGING THE INFECTION-CONTROL PARADIGM FROM OFF-LINE TO REAL-TIME - THE EXPERIENCE AT MILLARD-FILLMORE-HEALTH-SYSTEM

In 1993, several departments at Millard Fillmore Health System joined efforts to initiate a new approach to infection control. The main emph asis of this program is to move infection control to a real-time mode to manage patient outcomes daily. The principal objective was to decre ase the number of nosocomial infections by 10%, with a particular emph asis on surgical-site infections. Besides real-time surveillance, we a re critically evaluating several aspects of the management of nosocomi al infections. High-level computer support has been the framework upon which this program was built. We have microcomputers that are linked directly to microbiology, pharmacy, billing, and admissions, downloadi ng data several times daily. An expert software system merges all of t he data, and from this we can target patients for real-time interventi ons. The computer system allows all inpatients to be screened for eith er infection control or antibiotic management interventions on a daily basis, with minimal time being spent on data collection and maximal e fforts devoted to interventions at the bedside. Additionally, the infe ction management program will assist in maintaining the extraordinaril y low expenditures on antimicrobial agents. During 1993, the Millard F illmore Health System spent $924,884 on antibiotics, an amount approxi mately 50% that of comparably sized hospitals.