Cost-containment using an outcome-based best practice model for the management of MRSA

Prior to 1991, most patients at Christ Hospital and Medical Center from whom methicillin-resistant Staphylococcus aureus (MRSA) was cultured were isolated and treated with systemic antibiotics, irrespective of whether they were colonised or infected. The result of this practice was a confused, un-coordinated approach to the management of MRSA patients with a negative effect on the quality and cost of patient care. An interdisciplinary team set about developing and implementing a Best Practice Guideline over the years 1991 and 1992. This guideline provided a separate approach to infected and colonised patients. This intervention led to a decreased average length of stay in hospital of over 10 days, a reduction in the readmission rate of these patients from 8.7% in 1990 to 2.7% in 1992, and resulted in total cost savings of over $1.9 million.