Standard 3.2.1 of the The National Safety and Quality Health Service Standards in Australia states “Surveillance systems for healthcare associated infections are in place”.
If I could wave the magic wand, the standard I would like to see would say something like this, “Electronic surveillance systems for healthcare associated infections are in place in alignment with the national surveillance program” (it’s a big wand).
It’s a fact that very few healthcare facilities have dedicated HAI surveillance software, which means that for much of it, surveillance continues to be a manual, labour intensive activity. Not only is this burdensome, we also know it influences data quality. Why don’t we all use electronic surveillance software (ESS)? Capital expenditure aside, maybe its because ICPs (and others) aren’t convinced of their value i.e. what effect does it have on day to day practice, how does it influence the overall infection prevention program?
In a recent systematic review published in the Journal of Hospital Infection, we sought to establish the impact of ESS on infection prevention. We were able to identify 16 papers in a search from 2006 to 2016. The review can be accessed here
There was much variation in the studies, so it was difficult make any strong conclusions. However, we did find that every paper described a marked reduction in time taken to collect data and ascertain cases. This is clearly a good thing for the ICP collecting data, but I don’t suspect that saved time is spent sitting around peeling grapes. Its possible that the ESS allowed them to broaden their surveillance activities, provide more accurate and better quality data, respond to outbreaks quicker, undertake local research projects, enable more detailed reports for the clinicians (and less detailed dashboards for their Executives), not to mention standardise data for public reporting and informing the build of algorithms for greater efficiency.
Unfortunately we cant really be sure how an ESS influences (benefits) infection prevention because we don’t have the data. As we conclude in our paper, we need specific research exploring the effect of ESS on infection prevention as a primary outcome, and whether this has any impact on infection and /or patient outcomes.
It would be very interesting to know if any hospitals with ESS have explored this issue, or if those who are moving towards implementing an ESS have considered some metrics around the benefits.