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Hospital Outreach Unit: Local public health and HAIs. Dawn Terashita MD, MPH Acute Communicable Disease Control Los Angeles County Department of Public Health dterashita@ph.lacounty.gov November 2012. Background History. In 2002, healthcare-associated infections consisted of
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Hospital Outreach Unit:Local public health and HAIs Dawn Terashita MD, MPH Acute Communicable Disease Control Los Angeles County Department of Public Health dterashita@ph.lacounty.gov November 2012
Background History • In 2002, healthcare-associated infections consisted of • Investigation of hospital outbreaks • Outreach & surveillance for antimicrobial resistance & blood borne pathogens.
Background History • In early 2003, during the SARS situation, BT LPHNs assisted in infection control and prevention in the hospital setting • In November 2003, ACDC created the new Hospital Outreach Unit
Hospital Outreach Unit (HOU) Mission • To enhance emerging infectious disease preparedness and response efforts and improve hospital disease reporting by hospitals in LAC through strengthened communications, collaboration, and consolidations of resources
Summary • 102 licensed acute care hospitals • 174 infection preventionists • HOU divided the county into 5 areas • Each area is assigned a Liaison Public Health Nurse
Hospital Outreach Unit: Objectives • Collaboration and communications between Public Health and hospitals • Bioterrorism and pandemic disease preparedness and response • Hospital outbreak investigations • Healthcare-associated infection prevention and surveillance • Mandatory disease reporting • Identify and respond to new and emerging threats
GOAL 1: Prevent • Infection Control Education • Visit every hospital at least annually • Attend infection control committee meetings • Promote WEBvCMR • Distribute educational materials • Distribute disease alerts such as measles alerts • Review the pandemic flu plan • Attend training, table-tops and exercises • Give presentations
GOAL 2: Detect and Report • 100% LAC hospitals now using NHSN • 100% LAC hospitals have conferred rights to LADPH • Validation of CLABSI, MRSA and VRE BSI, C. diff NHSN data completed on 20 LAC hospitals • CRKP surveillance June 1, 2010 to July 31, 2012
GOAL 3: Investigate • Hospital Outbreak Investigation • Site visits & chart review • Collect specimens from patients & environmental areas • Interview staff, etc.
Other Hospital Outreach Unit Activities • Liaison between ACDC/Public Health and non-acute healthcare settings such as: • Hospital based SNF and dialysis centers • Acute psychiatric hospitals • Large clinics • Jail medical services • Keep key hospital contact information up-to-date, including email, fax, and phone numbers • IP, ICC, ED, Lab, Pharmacy, ID, etc.
Other HAI Activities • California Healthcare-Associated Infections Advisory Working Group • Hospital Association of Southern California HAI Taskforce • National Healthcare Safety Network (NHSN) State User Group • CSTE Nosocomial Infections Workgroup
CDPH HAI Program Collaboration • ARRA funded collaboration with CDPH • 1 HAI field staff assigned to Los Angeles County (Feb 2010 to Dec 2011) • HAI and HOU staff will visit every hospital • Ensure enrollment into NHSN with rights conferred to CDPH and LACDPH • Serve as consultant for HAI issues • Evaluate data collection and reporting methods
Future Direction • Increase outreach to hospitals to alleviate infection control deficits • Continue expansion of HAI activities to non-acute care settings (SNFs, dialysis centers, ambulatory surgery centers) • Initiate analysis of NHSN data
