Infection Prevention

As many older patients are affected by Clostridium difficile (C.diff) in hospital settings, South Nassau Communities Hospital created an ongoing multidisciplinary task force to help improve processes in four areas: environmental cleaning practices, overprescribing antibiotics, inappropriate diagnostic testing and clinical care of C.diff patients.

After conducting a system wide education program, the hospital established a C.diff protocol which requires patients to be in private, isolated rooms until discharged. The hospital also implemented other initiatives to reduce infection, such as:

• Started an antimicrobial stewardship campaign to regulate appropriate usage of antibiotics for the duration of therapy.
• Invested in a steam vapor system to eliminate C.diff spores from surfaces in patients' rooms.
• Developed an algorithm in EMR to use the most precise polymerase chain reaction testing for C.diff.

These practices led to a decrease in C.diff incidence rates. In 2014, it dropped to 12.3 per 10,000 patient days and by 2016, it reduced to 6.4.

This case study is part of the HANYS Triple Aim series highlighting how New York hospitals are improving health, enhancing quality and reducing costs. Hospitals, nursing homes and home care agencies across New York state are pursuing the Triple Aim. In spite of fiscal constraints, HANYS members are embracing the challenge of transforming health care and are implementing new and innovative approaches to delivery.