Simulation shows hospitals that cooperate on infection control obtain better results than hospitals acting alone

Abstract

Efforts to control life-threatening infections, such as with methicillin-resistant Staphylococcus aureus (MRSA), can be complicated when patients are transferred from one hospital to another. Using a detailed computer simulation model of all hospitals in Orange County, California, we explored the effects when combinations of hospitals tested all patients at admission for MRSA and adopted procedures to limit transmission among patients who tested positive. Called "contact isolation," these procedures specify precautions for health care workers interacting with an infected patient, such as wearing gloves and gowns. Our simulation demonstrated that each hospital's decision to test for MRSA and implement contact isolation procedures could affect the MRSA prevalence in all other hospitals. Thus, our study makes the case that further cooperation among hospitals--which is already reflected in a few limited collaborative infection control efforts under way--could help individual hospitals achieve better infection control than they could achieve on their own.

EXHIBIT 3. Number Of MRSA Cases Averted Per Year Countywide By Implementing Surveillance And Contact Isolation In The Highest-Capacity Hospitals At Varying Contact Isolation Compliance Rates Over 10 Simulated Years

SOURCE Author-generated data. NOTES For number of highest-capacity hospitals, starting with the largest and progressively adding the next-largest by capacity. MRSA is methicillin-resistant Staphylococcus aureus.