Reducing Hospital-Acquired Clostridium difficile Infections

In 2013, the facility's hospital-onset (HO) infection rate for Clostridium difficile (C. diff) had been trending upward over multiple quarters.

Despite implementing universal gloving, an increased emphasis on hand hygiene and antibiotic stewardship measures, the facility ended the year with a rate that was more than double its target. An interdisciplinary team consisting of the chief medical officer, the director of quality, the medical director for infection control, two infection preventionists and representatives from the pharmacy, housekeeping and nursing departments worked together to identify key areas for improvement.

The team devised an interdisciplinary bundle with an implementation goal of 90 days. The key components of the bundle were implemented throughout the first quarter of 2014; the bundle elements were dynamic and continuously refined over the next two quarters. During this time, the HO C. diff rate dropped 34 percent, and by the end of 2014, the facility achieved a 48 percent reduction in HO C. diff. First quarter 2015 data demonstrate a continued reduction in the incidence of C. diff with a sustained reduction of 54 percent over the last 15 months.

This case study is part of the Illinois Health and Hospital Association's annual Quality Excellence Achievement Awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals and health systems in continually improving and transforming health care in the state. These organizations are improving health by striving to achieve the Triple Aim—improving the patient experience of care (including quality and satisfaction), improving the health of populations, and reducing the per capita cost of health care—and the Institute of Medicine's six aims for improvement—safe, effective, patient centered, timely, efficient, and equitable. To learn more, visit

Related Resources

Case Studies
As many older patients are affected by Clostridium difficile (C.diff) in hospital settings,
Case Studies
Antibiotic stewardship was implemented in 2011 and focuses on five 'D's': Drug, De-escalation of therapy, Discontinuation of therapy, Dose and Diag
Chairperson's File
National attention to the issue of antibiotic stewardship is increasing.
Media Advisory: The Centers for Disease Control and Prevention (CDC) today issued a call to action on antibiotic stewardship.
The Evaluation and Research on Antimicrobial Stewardship's Effect on Clostridium difficile (ERASE C. difficile) Project
A recent study of 39 children's hospitals revealed 16 organizations have antimicrobial stewardship programs in place and another 15 hospitals are p