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    Impact of Statewide Prevention and Reduction of (SPARC), a Maryland public health-academic collaborative: an evaluation of a quality improvement intervention

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    Author
    Rock, Clare
    Perlmutter, Rebecca
    Blythe, David
    Bork, Jacqueline
    Claeys, Kimberly
    Cosgrove, Sara E
    Dzintars, Kate
    Fabre, Valeria
    Harris, Anthony D
    Heil, Emily cc
    Hsu, Yea-Jen
    Keller, Sara
    Maragakis, Lisa L
    Milstone, Aaron M
    Morgan, Daniel J
    Dullabh, Prashila
    Ubri, Petry S
    Rotondo, Christina
    Brooks, Richard
    Leekha, Surbhi
    Show allShow less

    Date
    2021-12-09
    Journal
    BMJ Quality & Safety
    Publisher
    BMJ Publishing Group
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1136/bmjqs-2021-014014
    Abstract
    To evaluate changes in Clostridioides difficile incidence rates for Maryland hospitals that participated in the Statewide Prevention and Reduction of C. difficile (SPARC) collaborative. Pre-post, difference-in-difference analysis of non-randomised intervention using four quarters of preintervention and six quarters of postintervention National Healthcare Safety Network data for SPARC hospitals (April 2017 to March 2020) and 10 quarters for control hospitals (October 2017 to March 2020). Mixed-effects negative binomial models were used to assess changes over time. Process evaluation using hospital intervention implementation plans, assessments and interviews with staff at eight SPARC hospitals. Maryland, USA. All Maryland acute care hospitals; 12 intervention and 36 control hospitals. Participation in SPARC, a public health-academic collaborative made available to Maryland hospitals, with staggered enrolment between June 2018 and August 2019. Hospitals with higher C. difficile rates were recruited via email and phone. SPARC included assessments, feedback reports and ongoing technical assistance. Primary outcomes were C. difficile incidence rate measured as the quarterly number of C. difficile infections per 10 000 patient-days (outcome measure) and SPARC intervention hospitals' experiences participating in the collaborative (process measures). SPARC invited 13 hospitals to participate in the intervention, with 92% (n=12) participating. The 36 hospitals that did not participate served as control hospitals. SPARC hospitals were associated with 45% greater C. difficile reduction as compared with control hospitals (incidence rate ratio=0.55, 95% CI 0.35 to 0.88, p=0.012). Key SPARC activities, including access to trusted external experts, technical assistance, multidisciplinary collaboration, an accountability structure, peer-to-peer learning opportunities and educational resources, were associated with hospitals reporting positive experiences with SPARC. SPARC intervention hospitals experienced 45% greater reduction in C. difficile rates than control hospitals. A public health-academic collaborative might help reduce C. difficile and other hospital-acquired infections in individual hospitals and at state or regional levels.
    Rights/Terms
    © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
    Keyword
    clinical practice guidelines
    healthcare quality improvement
    patient safety
    quality improvement
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/17380
    ae974a485f413a2113503eed53cd6c53
    10.1136/bmjqs-2021-014014
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