Why Clinical Surveillance is Critical for a Modern Hospital
According to The Center for Disease Control and Prevention (CDC), antibiotic resistance is one of the biggest public health challenges of our time. Antimicrobial resistance each year causes more than 2 million infections, and 23,000 deaths. To put it in other terms, it causes the equivalent of a Boeing 747 crash every week. Anytime antibiotics are overprescribed or prescribed inappropriately (also known as a drug/bug mismatch), they can become less effective in treating infections. Patients can die unnecessarily, and massive amounts of resources are lost to ineffective care and dissipated productivity. The CDC estimates that 30-50 percent of antibiotics prescribed in hospitals are either inappropriate or unnecessary.
The Problem with a Manual Approach to Clinical Surveillance
In some hospitals, intervention for adverse drug events and other aspects of infection control and clinical surveillance are still done manually. The drawbacks of performing these tasks manually instead of using a Clinical Surveillance software system include:
- Issues are detected only after they happen (vs predictive analytics with software)
- Unnecessary additional efforts are spent manually monitoring events that can otherwise be performed seamlessly, 24 hours a day using a software system.
- Increased adverse events and clinical errors
- Higher risk of reduced patient outcomes and safety
- Slower adaptation to changes in regulations and reporting, guideline updates, and the evolution of the scale and scope of surveillance
In addition, the COVID-19 pandemic has greatly added to these challenges. The combination of infection control, antibiotic stewardship and COVID-19 surveillance can be overwhelming to a healthcare system, whether at the level of a single hospital or a network of hospitals.
III. Five Key Questions to Ask when Evaluating Clinical Surveillance Software
As Clinical Surveillance Software Systems become increasingly critical to a modern hospital, below are five key questions to ask when evaluating any system:
- Does the system require separate installations for each hospital facility? The system should be able to scale to multiple sites quickly. In addition, there should be an integrated view across multiple facilities, networks of hospitals (or VISNs for VA hospitals), or even a country-wide view for a large network such as the US Department of Veterans Affairs (VA) hospitals.
- How long is the “Go Live” date after signing the initial contract? It should be 90 days or less.
- Is the system directly integrated with the EHR (Electronic Health Record) and other systems of the hospital in order to eliminate hours of labor-intensive manual extraction and review of the data? Data extraction from the EHR should not require the services of a third party vendor, as this imposes additional risks and costs.
- Can the Clinical Surveillance System integrate with other hospital systems such as the Perioperative/Anesthesia Information Management System (PIMS/AIMS) data (e.g. PICIS) of the hospital? This will enable the detection of specific infections such as ventilator associated infections and can allow alerts to be set up when equipment such as a central line or a ventilator has reached a specified timeline.
- Are previous years of retrospective data immediately available? This enables the detection of antimicrobial resistance trends emerging at slower rates (e.g., vancomycin MIC drift). The system should immediately provide a minimum of 5 years of retrospective data.
Clearly there will also be other considerations depending on the particular circumstances of your hospital or hospital network, but the above five questions are absolutely critical to ask in almost all Clinical Surveillance evaluations. If we can help further as you begin the process of determining the Clinical Surveillance needs of your hospital, please don’t hesitate to contact us and we would be happy to assist in any way we can.