Through its work and partnerships with Maine nursing homes and hospitals, New England QIN-QIO staff recognized that in both the nursing home and hospital setting, leaders were targeting the same goal – a reduction of C. difficile rates in the patients they serve. According to the Centers for Disease Control and Prevention (CDC), the germ C. difficile is a serious threat to older adults who take antibiotics and receive medical care, and was estimated to cause almost half a million infections in the United States in 2011, and 29,000 died within 30 days of the initial diagnosis. However, in Maine, there was not an organized process in place for the nursing home system and the hospital system to come together to target this issue as a community.
In partnership with the Maine CDC and Maine Hospital Association, the Maine QIN-QIO staff took the initiative to help coordinate an effort to bring together hospitals and nursing homes to reduce C. difficile, inviting leaders to join them in a six-month learning collaborative to focus on C. difficile reduction and prevention efforts. The collaborative included education and peer networking at no cost, with the goal of bringing both hospitals and nursing facilities together. Supplying CDC reports of hospital and nursing home C. difficile rates data dating back to January 2017, the QIN-QIO staff combined the reports to show rates of the collaborative participants across their communities.
During the first meeting, nursing home and hospital leaders worked jointly on developing a collaborative assessment based on the CDC Targeted Assessment for Prevention tool on C. difficile education and protocol as a pre-test for their facility staff. In response to offering this pre-test, the QIN-QIO received 400 responses from collaborative participants to summarize and compile. A QIN-QIO staff member said, “the responses to the TAP assessment were eye-opening for the infection preventionists, who now better understand how to strategically plan for education.”
Each facility who attended the initial informational meeting was invited to commit to six additional meetings consisting of four one-hour teleconference meetings and two face-to-face meetings. Through working with this group of facility leaders, the QIN-QIO offers educational resources on the prevention of C. difficile for them to share with front line staff.
By starting this collaborative, the QIN-QIO has engaged nursing homes and hospitals across all corners of the state to focus on a strategic partnership to reduce C. difficile rates. The QIN-QIO’s work has resulted in a facilitated opportunity to collaborate, data analysis of NHSN-reported monthly rates, and education for direct care providers.