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Published on: July 13, 2019
Implementation and impact of a business intelligence system on catheter-related bloodstream infections: a multicenter
Po-Yen Huang1,2,3, Chien-Long Shih4, Yun-Ting Chung5
1Division of Infectious Diseases, Department of Medicine, Chang Gung Memorial Hospital, No. 5, Fu-Hsin Street, Guishan, 333, Taoyuan, Taiwan. pyhuang@gmail.com.
Insights
A business intelligence system and infectious disease specialist intervention reduced catheter-related bloodstream infections (CRBSI) in intensive care units (ICUs). This proactive surveillance approach improved patient safety and infection control outcomes in high-risk settings.
Area of Science:
- Healthcare quality improvement
- Infectious disease surveillance
- Business intelligence in healthcare
Background:
- Central-line-associated bloodstream infections (CLABSI) and catheter-related bloodstream infections (CRBSI) increase mortality and healthcare costs.
- Proactive surveillance is crucial for managing these infections.
- A hospital-wide business intelligence (BI) system coupled with infectious disease (ID) specialist intervention was implemented to support CRBSI surveillance.
Purpose of the Study:
- To evaluate the impact of a hospital-wide BI system and ID specialist intervention on CRBSI incidence.
- To assess trends in CRBSI incidence and central venous catheter (CVC) duration.
- To analyze the effectiveness of the intervention in different hospital settings (ICU vs. non-ICU).
Main Methods:
- Multicenter, retrospective analysis of a quality improvement initiative (January 2019 - September 2024).
- BI system identified high-risk patients using criteria: leukocytosis, elevated C-reactive protein, prolonged catheter duration, and fever.
- Interrupted time series (ITS) analysis evaluated quarterly CRBSI incidence and CVC duration trends, with stratified analysis for ICU and non-ICU settings.
Main Results:
- Overall CRBSI incidence trend was not significantly affected by the intervention.
- A statistically significant decrease in CRBSI incidence trend was observed in the ICU setting (slope change Δ = -0.737/quarter, P = 0.045).
- No significant change in CRBSI incidence trend was observed in the non-ICU setting. Average CVC duration changes were varied and often non-significant.
Conclusions:
- A hospital-wide BI system combined with ID specialist expertise significantly reduced CRBSI incidence over time, particularly in high-risk ICU settings.
- This technology-focused, expert-supported approach shows promise for improving patient safety.
- The findings highlight the potential of integrated BI systems and specialist intervention for effective infection control.
Background:
Central-line-associated bloodstream infections (CLABSI) and catheter-related bloodstream infections (CRBSI) are associated with increased mortality and healthcare costs. We describe implementing a hospital-wide business intelligence (BI) system coupled with infectious disease (ID) specialist intervention to support proactive CRBSI surveillance.
Methods:
We conducted a multicenter, retrospective analysis of a quality improvement initiative from January 2019 to September 2024. A BI system used predefined criteria (leukocytosis, elevated C-reactive protein, prolonged catheter duration, and fever) to identify high-risk patients. Starting in July 2022, ID specialists reviewed these cases and provided advice on catheter reassessment. We employed interrupted time series (ITS) analysis to evaluate quarterly trends in CRBSI incidence and mean central venous catheter (CVC) duration, adjusting for seasonality and conducting a stratified analysis for ICU versus non-ICU settings.
Results:
A total of 5090 patients with 6,750 CVC placements were included. While the overall trend for CRBSI incidence was not significantly affected by the intervention, the stratified analysis showed a statistically significant decrease in the CRBSI incidence trend within the ICU setting (slope change Δ = - 0.737/quarter, P = 0.045). No significant change was seen in the non-ICU setting. The intervention's effect on average CVC duration was less evident, with varied and often non-significant changes across different sites.
Conclusion:
A hospital-wide BI system, combined with ID specialist expertise, was associated with a significant reduction in CRBSI incidence over time, especially in the high-risk ICU setting. This technology-focused, expert-supported approach offers a promising approach to improving patient safety and infection control outcomes.
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