Wednesday, November 17, 2010

$34 Million to Fight HAIs

AHRQ awarded $34 million in contracts and grants to focus on Healthcare-Associated Infections (HAIs). AHRQ is collaborating with CDC, CMS, NIH, and the Office of Healthcare Quality to develop 22 projects to address research gaps and to accelerate the adoption of evidence-based approaches for HAI prevention.

Several of the projects being funded involve data systems. One project at Children’s Hospital of Philadelphia received grant funding for to improve the Pediatric Health Information System (PHI) that links laboratory results and radiology reports from member children’s hospitals along with administrative data.

The funding will use the PHIS+database to conduct four pediatric comparative effectiveness studies. The pediatric comparative effectiveness studies will:

• Compare the effectiveness of aminopenicillins, second-generation cephalosporinas, and macrolides in children hospitalized with community-acquired pheumonia
• Compare the effectiveness of fundoplication versus feeding via gastrojejunal tube for treatment of gastroesophageal reflux disease in neurologically impaired children
• Compare the effectiveness of monotherapy antibiotic regimens versus two or three-drug combinations of antibiotics in the initial post-operative treatment of children with advanced appendicitis
• Compare the effectiveness of antibiotics active against MRSA versus non-MRSA active antibiotics in the initial treatment of acute osteomyelitis.

Another project at Thomson Reuters will further develop the Healthcare Cost and Utilization Project (HCUP) data infrastructure to provide baseline estimate of HAIs in the ambulatory surgery setting. Implementation strategies aimed at decreasing the occurrence of HAIs in ambulatory surgery settings will also be evaluated.

The objective is to:

• Increase the ability to link patients across time and setting within HCUP databases
• Evaluate the feasibility of developing a national readmission data file to produce national estimates of readmissions to U.S. hospitals, including readmissions for HAIs
• Develop a national ambulatory surgery database
• Develop a toolkit for the states to add clinical data to administrative data with an emphasis placed on “present on admission” a critical data element to distinguish HAIs that develop during a hospitalization

Indiana University-Purdue University at Indianapolis will work on a project to build upon an existing health information exchange and to automate the processing of microbiology reports coming into the exchange that will identify patients with infections from multidrug resistant organisms. The project will also implement clinical decision support for HAIs caused by multidrug-resistant organisms.

For more information on the projects, go to or email James Cleeman, M.D., Senior Medical Officer, Center for Quality Improvement and Patient Safety, AHRQ, at