Overview of the Infection Control Assessment and Response (ICAR) Program

Transcription

1 Overview of the Infection Control Assessment and Response (ICAR) Program Tammy Hale MSN, RN ICAR Nurse Specialist September 28 th, 2016 Goal to improve infection control capacity Voluntary, Non- regulatory program Funded by CDC ICAR Program Acute Care, Long Term Care, Ambulatory Care & Dialysis Collaboration with APIC - MN Minnesota Hospital Association Stratis Health 1

2 Goals of ICAR Strengthen relationships Assess areas for improvement Work in collaboration Provide resources ICAR Participating Facilities Gain assistance in developing and implementing plans to mitigate infection control gaps Identify and coordinate training Provide on-going consultation and technical assistance to gauge progress 2

3 National Priorities for Infection Prevention Infection Control and Program Infrastructure Hand Hygiene Personal Protective Equipment Device Associated Infections Antibiotic Stewardship Environmental Cleaning Enroll in ICAR Discuss ICAR within organization Complete facility specific assessment Return assessment to ICAR team 3

4 Sample Assessment Onsite Visit Conversation of how to partner Dialogue with facility (i.e. administration, IP, environmental services) Need conference room or office Identify facility challenges and priorities Will take about 2 hours 4

5 What s Next Written report to facility References provided On-going follow-up and support Educational opportunities Examples of ICAR support Response to ongoing facility questions s/phone consultation On-site follow-up upon request Assistance with educational needs 5

6 Jacy Walters, PhD, MPH ICAR Program Director/Epidemiologist Ginnie Bren, MPH, RN, CIC, FAPIC ICAR Infection Prevention Specialist Pam Gahr, MPH ICAR Program Epidemiologist Tammy Hale, MSN, RN ICAR Infection Prevention Specialist ICAR Staff Questions? ** Come see us at our APIC booth 6

7 One Health Antibiotic Stewardship Activities Minnesota Dept. of Health Amanda Beaudoin, DVM, PhD Director of One Health Antibiotic Stewardship September 28 th, 2016 MDH and Antibiotic Resistance Minnesota Antibiotic Resistance Collaborative (MARC) (early 2000s) Guidance and activities for outpatient and long-term care Antibiotic stewardship conferences held with state hospital association and quality improvement organizations ( ) Minnesota guidance and tools Acute care stewardship toolkit (2012) Long-term care stewardship toolkit (2014) Challenges: Connecting facilities with tools, implementation support Poor understanding across human, animal, environmental health Use strategic plan process to re-empower coalition and build relationships 7

8 One Health Antibiotic Stewardship Collaborative Multi-partner initiative to address antibiotic use Inter-agency approach by government MDH Department of Agriculture Board of Animal Health Pollution Control Agency Stakeholders from all fields University of Minnesota Hospital networks, individual practitioners Health advocate groups (e.g., CHAIN, MHA) Agricultural production groups One Health Stewardship Strategic Plan Mission Provide a collaborative environment to promote judicious antibiotic use and to reduce the impact of antibiotic resistant pathogens of human, animal, and environmental health importance Vision Minnesota leaders in human, animal, and environment health will work together to raise awareness and change behaviors to preserve antibiotics and treat infections effectively 8

9 Strategic Plan Goals Promote understanding of One Health antibiotic stewardship across disciplines Improve human antibiotic stewardship Improve animal antibiotic stewardship Develop an antibiotic footprint tool and improve understanding of environmental impact on resistance Strategic Plan Strategies Promote understanding of one health antibiotic stewardship across disciplines Share one health targeted resources and current data by online platform Develop a one health antibiotic stewardship communications plan Hold a series of in-person one health exchanges between human, animal, and environmental practitioners Support public engagement on one health antibiotic stewardship Support one health antibiotic stewardship curriculum 9

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11 Strategic Plan Strategies Improve human antibiotic stewardship efforts Make tools available to track antibiotic use and other components of antibiotic stewardship across the continuum of care Identify healthcare facility needs for tracking data, benchmarking, and antibiotic use policies Develop state human health antibiotic goals specific to syndromes and settings Utilize honor roll recognition system for healthcare facilities 11

12 Strategic Plan Strategies Improve animal antibiotic stewardship efforts Implement and communicate national antibiotic use goals for livestock Promote producer quality certification program best practices Support veterinary feed directive and farmer/feed stores capacitybuilding Facilitate public engagement on animal antibiotic stewardship Increase capacity of veterinary diagnostics laboratory Improve access to stewardship resources for companion animal and equine veterinarians Strategic Plan Strategies Develop an antibiotic footprint tool and improve understanding of environmental considerations Develop a living antibiotic footprint Target needs and improve adherence to guidelines for disposal 12

13 Antibiotic Footprint Model What s Next in Human Stewardship 2017 Antibiotic Stewardship Conference Work through ICAR to understand gaps and needs for facility stewardship programs Develop support mechanisms Support facilities in CMS rule changes Conduct analyses of prescribing data Understand prescribing practices Set goals for prescribing Develop tiered honor roll system to recognize facility stewardship efforts 13

14 One Health Workgroup Affiliations Abbott Northwestern Hospital Allina Health Association for Professionals in Infection Control and Epidemiology Minnesota Blue Cross Blue Shield Children s Hospitals and Clinics of Minnesota Emergency Physicians Professional Association- Minnesota HealthEast HealthPartners Hennepin County Medical Center Land O Lakes Leading Age Minnesota M Health Mayo Clinic Merck Research Labs Metropolitan Council Minnesota Association of Physician Assistants Minnesota Beef Council Minnesota Board of Animal Health Minnesota Board of Medical Practice Minnesota Board of Veterinary Medicine Minnesota Department of Agriculture Minnesota Department of Health Minnesota Farm Bureau Minnesota Farmers Union Minnesota Hospital Association Minnesota Medical Association Minnesota Milk Producers Association Minnesota Nurse Practitioners Minnesota Pollution Control Agency Minnesota Pork Board Minnesota State Cattlemen s Association Minnesota Turkey Growers Association North Dakota State University Park Nicollet Regions Hospital Sanford Health St. Paul Infectious Disease Associates, Ltd. Stratis Health University of Minnesota University of St. Thomas US Geographical Survey Veterans Affairs Healthcare System Zoetis Animal Health MDH Contacts for One Health Stewardship Amanda Beaudoin, DVM, PhD Director of One Health Antibiotic Stewardship amanda.beaudoin@state.mn.us Ruth Lynfield, MD State Epidemiologist ruth.lynfield@state.mn.us Thank you! 14

15 Emergency Preparedness and Response - Healthcare Preparedness Program Angie Koch, MPH Planning Director State Medical Surge MDH HPP Ebola Grant Crisis Standards of Care Project September 28, 2016 Emergency Preparedness and Response HPP Ebola Grant MN received $5.5 million: Two part grant: Part A and Part B MDH-EPR University of Minnesota Medical Center West Bank Campus MDH-IDEPC Mayo Clinic Hospital St. Mary s Campus, Rochester MN 8 Coalitions Unity Hospital in Fridley Children s Hospitals and Clinics St. Paul 15

16 HPP Ebola Grant Part A Part A Requirements Regional coalitions, assessment, state and interregional treatment center Staffing focused on CONOPs with transportation plan Regional Coalition Assessments Annual exercise among 8 coalitions CONOPs final draft in progress HPP Ebola Grant Part B Building University of Minnesota Medical Center capabilities HHS Region V treatment center Trainings, staff, exercises Inter-state Region V (MN, WI, IL, IN, MI, OH, Chicago) transportation plan Ground and air transport Waste management Fatality Management Legal framework 16

17 Project Managers For Further Information on MDH Ebola Efforts, please contact: Pat McQuillan at Alex Bambrick at Crisis Standards of Care Goal: Do the greatest good for the greatest number of persons you can based upon the resources available Emergency Preparedness and Response 17

18 Five Key Elements for all CSC Plans (from Institute of Medicine) A strong ethical grounding based transparency, consistency, proportionality, and accountability Integrated and ongoing community and provider engagement, education, and communication The necessary legal authority and legal environment in which CSC can be ethically and optimally implemented Clear indicators, triggers, and lines of responsibility Evidence based clinical processes and operations What are we talking about? Resupply limitations on local, regional, state, federal resource caches Limited access to medical countermeasures Impacted patient transfer Catastrophic disaster Multiple healthcare access points Limited resources Similar healthcare delivery strategies 18

19 Working Groups/Key Areas Crisis Standards of Care Steering Group (CSCSG) Ethics EMS Public Engagement Clinical (SAT) Legal Triggers and Indicators Indicator: A measurement, event, or other data that is a predictor of change in demand for health care service delivery or availability of resources. Trigger: A decision point that is based on changes in the availability of resources that requires adaptations to health care services delivery along the care continuum (contingency, crisis, and return toward conventional). 19

20 CSC Steering Group Provides oversight and recommendations Establish and oversee work groups aimed at successful completion of developing the Crisis Standards of Care Plan. Collaborate with the MDH Science Advisory Team Ethical Framework Requirements for ethical crisis standards of care planning and development: Fairness Duty to care Duty to steward resources Transparency Proportionality Accountability Source: Institute of Medicine,

21 Ethical and Legal Foundation Mechanism to respond to the ethical and moral values of patient care Address the legal barriers for the provision of optimal and ethical medical care and public health for emergency/crisis preparedness and response. Develop generally applied principles of public health emergency ethics Produce a public health emergency code of ethical behavior to guide decision making processes in crisis scenarios Emergency Medical Services (EMS) What we know Likely first to be impacted and implement plan Decision making strategies in place for PSAP and EMS response Success only achieved with input from experts Desire to take care of our community and support public s health What is to be developed Statewide decision making framework on triaging and altering or delaying EMS response Acquiring and adapting other transport resources and personnel Assure legal and administrative authorities and processes are in place for decision making 21

22 Clinical Patient Care: Strategies for Scarce Resources Situations A standardized framework to assist Minnesota hospitals, clinics or primary care settings in determining how to extend resources when the need for specialized equipment and supplies such as ventilators and pharmaceuticals exceeds availability during a public health emergency Public Engagement Why public engagement? Essential principles of public engagement Public engagement strategies Session format Next Steps/Action Items 22

23 Project Managers Lead Project Manager: Erin McLachlan Legal: Arden Fritz EMS: John Urbach Public Engagement: Emily Moilanen Ethics: Angie Koch Thank you Angie Koch, MPH Planning Director State Medical Surge Minnesota Department of Health Emergency Preparedness and Response