Online Program

Utilizing statistical process control tools and highly-detailed simulation for biosurveillance in intensive care units to control healthcare associated infections

Wednesday, November 6, 2013 : 1:30 p.m. - 1:50 p.m.

Jose Jimenez, MPH, MS, MEM, PhD, Virginia Bioinformatics Institute at Virginia Tech, Network Dynamics and Simulation Science Laboratory (NDSSL), Blacksburg, VA
Bryan Lewis, PhD, MPH, Social and Decision Informatics Laboratory, Virginia Bioinformatics Institute at Virginia Tech, Arlington, VA
Kaja Abbas, PhD, Department of Population Health Sciences, Virginia Tech, Blacksburg, VA
Tina Williamson, RN, MBA, Infection Control, Carilion Clinic, Roanoke, VA
Stephen Eubank, PhD, Network Dynamics and Simulation Science Laboratory, Virginia Bioinformatics Institute at Virginia Tech, Blacksburg, VA
Thomas Kerkering, MD, FACP, FIDSA, Carilion Clinic, Virginia Tech Carilion School of Medicine, Roanoke, VA
Objective: To determine the effectiveness of combining statistical process control and simulation tools to predict and control outbreaks of healthcare-acquired infections in Intensive Care Units. Background: In the United States, 1 in 20 hospitalized patients become infected every year with a healthcare associated infection (HAI), and 20% of HAI patients become infected in intensive care units (ICUs). Some of the complications of HAIs include increased morbidity, increase of drug-resistant infections, and a strain in the resources of healthcare systems. Statistical process control (SPC) tools have been used in healthcare settings to predict outbreaks. Based on these predictions, analysts make recommendations to assist stakeholders on control plans to mitigate the outbreak. Methods: Data has been collected for the patient population from a regional hospital in Southwest Virginia for one year through electronic medical records of patients and direct surveillance of healthcare professionals. A highly detailed synthetic representation of one of the hospital's ICUs was created using patient and healthcare worker data. Different infection scenarios were used to simulate outbreaks within the ICU. SPC control charts were utilized to predict potential outbreaks in the ICUs. Specific types of control charts were more effective in identifying outbreaks on time. The simulated ICU biosurveillance scenarios are analyzed to derive useful inferences, which will assist in improving control plans for HAIs. Public health significance: The use of high performance simulation and biosurveillance of HAIs will assist in improving HAI prevention and control plans, and planning for optimal allocation of limited healthcare resources to reduce morbidity and mortality of patients with HAIs.

Learning Areas:

Biostatistics, economics
Communication and informatics
Protection of the public in relation to communicable diseases including prevention or control
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Compare multiple statistical control charts used in surveillance of healthcare associated infections. Identify the properties that make statistical control charts effective tools for surveillance. Discuss the benefits of highly-detailed, highly-resolved simulation in healthcare facility settings. Explain why simulated biosurveillance can assist in improving healthcare acquired infection prevention and control plans.

Keyword(s): Biostatistics, Simulation

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am conducting my MPH and PhD thesis and dissertation on the topic of healthcare acquired infections, focusing on simulation of healthcare facilities. I have presented on multiple occasions on this topic to include APHA 2012 Annual Meeting. I am also a Medical Service Corps officer.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.