Maaike S M van Mourik1, Stephanie M van Rooden2, Mohamed Abbas3, Olov Aspevall4, Pascal Astagneau5, Marc J M Bonten6, Elena Carrara7, Aina Gomila-Grange8, Sabine C de Greeff9, Sophie Gubbels10, Wendy Harrison11, Hilary Humphreys12, Anders Johansson13, Mayke B G Koek9, Brian Kristensen14, Alain Lepape15, Jean-Christophe Lucet16, Siddharth Mookerjee17, Pontus Naucler18, Zaira R Palacios-Baena19, Elisabeth Presterl20, Miquel Pujol8, Jacqui Reilly21, Christopher Roberts11, Evelina Tacconelli22, Daniel Teixeira3, Thomas Tängdén23, John Karlsson Valik18, Michael Behnke24, Petra Gastmeier24. 1. Department of Medical Microbiology and Infection Control, University Medical Center Utrecht, the Netherlands. Electronic address: M.S.M.vanMourik-2@umcutrecht.nl. 2. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands; Centre for Infectious Disease Epidemiology and Surveillance National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands. 3. Infection Control Programme, Geneva University Hospitals, Geneva, Switzerland. 4. Unit for Surveillance and Coordination, Public Health Agency of Sweden, Solna, Sweden. 5. Centre for Prevention of Healthcare-Associated Infections, Assistance Publique - Hôpitaux de Paris & Faculty of Medicine, Sorbonne University, Paris, France. 6. Department of Medical Microbiology and Infection Control, University Medical Center Utrecht, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands. 7. Infectious Diseases Section, Department of Diagnostics and Public Health, University of Verona, Italy. 8. Infectious Diseases Unit, Bellvitge Biomedical Research Institute (IDIBELL), Bellvitge University Hospital, Barcelona, Infectious Diseases Unit, Consorci Corporació Sanitària Parc Taulí, Barcelona, Spain. 9. Centre for Infectious Disease Epidemiology and Surveillance National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands. 10. Data Integration and Analysis Secretariat, Statens Serum Institut, Copenhagen, Denmark. 11. Healthcare Associated Infections, Antimicrobial Resistance and Prescribing Programme (HARP), Public Health Wales, UK. 12. Department of Clinical Microbiology, The Royal College of Surgeons in Ireland, Department of Microbiology, Beaumont Hospital, Dublin, Ireland. 13. Clinic for Infectious Diseases, Umea University, Sweden. 14. Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark. 15. Clinical Research Unit, Department of Intensive Care, Centre Hospitalier Universitaire Lyon Sud 69495, Pierre-Bénite, France. 16. Infection Control Unit, Hôpital Bichat-Claude Bernard Assistance Publique - Hôpitaux de Paris, Paris, France. 17. Infection Prevention and Control Department, Imperial College Healthcare NHS Trust, UK. 18. Department of Medicine Solna, Division of Infectious Diseases, Karolinska Institutet and Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden. 19. Unit of Infectious Diseases, Clinical Microbiology and Preventive Medicine, Hospital Universitario Virgen Macarena, Institute of Biomedicine of Seville (I. BIS), Sevilla, Spain. 20. Department of Infection Control and Hospital Epidemiology, Medical University of Vienna, Austria. 21. Safeguarding Health Through Infection Prevention Research Group, Institute for Applied Health Research, Glasgow Caledonian University, Scotland, UK. 22. Infectious Diseases, Research Clinical Unit, DZIF Center, University Hospital Tübingen, Germany; Infectious Diseases Section, Department of Diagnostics and Public Health, University of Verona, Italy. 23. Department of Medical Sciences, Uppsala University, Uppsala, Sweden. 24. National Reference Center for Surveillance of nosocomial Infections, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Berlin, Germany.
Abstract
INTRODUCTION: Healthcare-associated infections (HAI) are among the most common adverse events of medical care. Surveillance of HAI is a key component of successful infection prevention programmes. Conventional surveillance - manual chart review - is resource intensive and limited by concerns regarding interrater reliability. This has led to the development and use of automated surveillance (AS). Many AS systems are the product of in-house development efforts and heterogeneous in their design and methods. With this roadmap, the PRAISE network aims to provide guidance on how to move AS from the research setting to large-scale implementation, and how to ensure the delivery of surveillance data that are uniform and useful for improvement of quality of care. METHODS: The PRAISE network brings together 30 experts from ten European countries. This roadmap is based on the outcome of two workshops, teleconference meetings and review by an independent panel of international experts. RESULTS: This roadmap focuses on the surveillance of HAI within networks of healthcare facilities for the purpose of comparison, prevention and quality improvement initiatives. The roadmap does the following: discusses the selection of surveillance targets, different organizational and methodologic approaches and their advantages, disadvantages and risks; defines key performance requirements of AS systems and suggestions for their design; provides guidance on successful implementation and maintenance; and discusses areas of future research and training requirements for the infection prevention and related disciplines. The roadmap is supported by accompanying documents regarding the governance and information technology aspects of implementing AS. CONCLUSIONS: Large-scale implementation of AS requires guidance and coordination within and across surveillance networks. Transitions to large-scale AS entail redevelopment of surveillance methods and their interpretation, intensive dialogue with stakeholders and the investment of considerable resources. This roadmap can be used to guide future steps towards implementation, including designing solutions for AS and practical guidance checklists.
INTRODUCTION: Healthcare-associated infections (HAI) are among the most common adverse events of medical care. Surveillance of HAI is a key component of successful infection prevention programmes. Conventional surveillance - manual chart review - is resource intensive and limited by concerns regarding interrater reliability. This has led to the development and use of automated surveillance (AS). Many AS systems are the product of in-house development efforts and heterogeneous in their design and methods. With this roadmap, the PRAISE network aims to provide guidance on how to move AS from the research setting to large-scale implementation, and how to ensure the delivery of surveillance data that are uniform and useful for improvement of quality of care. METHODS: The PRAISE network brings together 30 experts from ten European countries. This roadmap is based on the outcome of two workshops, teleconference meetings and review by an independent panel of international experts. RESULTS: This roadmap focuses on the surveillance of HAI within networks of healthcare facilities for the purpose of comparison, prevention and quality improvement initiatives. The roadmap does the following: discusses the selection of surveillance targets, different organizational and methodologic approaches and their advantages, disadvantages and risks; defines key performance requirements of AS systems and suggestions for their design; provides guidance on successful implementation and maintenance; and discusses areas of future research and training requirements for the infection prevention and related disciplines. The roadmap is supported by accompanying documents regarding the governance and information technology aspects of implementing AS. CONCLUSIONS: Large-scale implementation of AS requires guidance and coordination within and across surveillance networks. Transitions to large-scale AS entail redevelopment of surveillance methods and their interpretation, intensive dialogue with stakeholders and the investment of considerable resources. This roadmap can be used to guide future steps towards implementation, including designing solutions for AS and practical guidance checklists.