To better manage and further reduce infection and infection risk for patients, healthcare professionals and the community, Sunnybrook’s Microbiology and Infection Control group focuses on faster, more accurate diagnostics to detect, identify and perform typing of potential pathogens, combined with active surveillance and screening for infections and auditing of compliance with infection prevention practices.
“To minimize the impact of infectious diseases on the health-care system,” says Dr. Andrew Simor, Head, Microbiology and Infectious Diseases, Sunnybrook, “we continue to provide accurate and rapid diagnosis and to lead in infection surveillance.”
Infectious diseases are of greater risk to people who are hospitalized for other complex medical conditions and may develop weakened immunity. Infections include Clostridium difficile, antibiotic-resistant organisms or ‘superbugs’ like MRSA (methicillin-resistant Staphylococcus aureus) and VRE (vancomycin-resistant Enterococcus,) and respiratory viruses like Influenza.
Sunnybrook Health Sciences Centre is one of only a handful of Canadian hospitals who lead in the use of molecular-based diagnostic technology which requires significant microbiology expertise. “Use of molecular-based technologies to enhance conventional methods yields more rapid and accurate diagnostics and helps us develop the most effective interventions to manage infection and better prevent transmission,” says Dr. Simor. “In some cases molecular-based technologies detect 30 to 40 per cent more strains of infection than with conventional methods and can isolate and confirm an organism’s drug sensitivity or resistance.”
“We also use an aggressive active surveillance and screening strategy,” says Dr. Mary Vearncombe, Medical Director, Infection Prevention and Control, Sunnybrook. “Our protocols which have been in place for years proactively identify patients at higher risk of infection and quickly identify new cases among current patients and newly-admitted patients from the community.”
Sunnybrook’s Microbiology and Infection Prevention and Control group also monitors for rigorous, evidence-based infection prevention practice and has implemented a Hand Hygiene initiative to include ongoing education and hand hygiene compliance audits; a core competency training and certification program every two years for all staff, and a supportive Healthy Workplace philosophy led by the hospital’s Joint Health and Safety Committee.
“Sunnybrook also supports accountability,” says Dr. Simor. For many years we have participated in the Canadian Nosocomial Surveillance Program (CNISP) which provides rates and trends of healthcare-associated infections across Canadian health-care facilities to develop benchmarks and inform national guidelines for better prevention. In line with and in advance of provincial Ministry requirements, Sunnybrook has publicly reported on its rates associated with Clostridium difficile, MRSA and VRE.
Says Dr. Vearncombe, “Sunnybrook continues to use CNISP data as a benchmark for our progress in preventing infections, and has maintained rates at or favourably below the national benchmark.”
Sunnybrook sees public reporting of infection rates as an opportunity to better lead in safety best practices and as part of its larger commitment to transparency to report the hospital’s performance. Communities can access Sunnybrook’s Strategic Balanced Scorecard to better understand the hospital’s goals and track its performance. There are three main areas monitored in the Scorecard including Quality of Patient Care, Research and Education, and Sustainability and Accountability, with Publicly Reported Safety Indicators (includes data on the presence of antibiotic resistant organisms and the Hospital Standardized Mortality Ratio) as part of Quality of Patient Care.
“As a publicly-funded institution Sunnybrook has an obligation to report on our successes and challenges,” says Michael Young, Executive Vice President, Corporate and Chief Administrative Executive. “We are committed to providing people with a window inside the organization and have made this Scorecard tool as user-friendly as possible. By looking at this section of the website, you should have a fairly good idea of how we’re doing.”
Sunnybrook’s Balanced Scorecard is presented in a comprehensive and interpretive way on www.sunnybrook.ca and uses easy-to-follow descriptions, short videos to explain various indicators and colour-coded charts to depict measurements.