Dr. Brad N. Doebbeling

Going to the hospital should be about being treated for your disease or injury not about battling a lethal antibiotic resistant superbug known technically as methicillin-resistant Staphylococcus aureus (MRSA) acquired in the hospital or community.

To combat MRSA, health services and informatics researchers from the Indiana University Center for Health Services and Outcomes Research, a program of the IU School of Medicine and the Regenstrief Institute, Inc., and VA Center of Excellence in Implementing Evidence-based Practice, have brought together the six major Indianapolis hospital systems. These competing hospital systems are now working together to save lives and reduce healthcare costs. It's a model to which other cities are already paying attention.

"Our success is based on a collaborative partnership between hospital leaders, providers and staff, informaticists, engineers and implementation scientists. We are using lean redesign and implementation practices to empower staff to reengineer the health care system and foster consistently quality care. Our informaticians are making data available from microbiology and infection control processes to help with more timely isolation and track progress. This level of data sharing to improve care is a model for the country," said Bradley N. Doebbeling, M.D., MSc, Department of Medicine Professor of Health Services Research at the IU School of Medicine, Director of the IU Center for Health Services Outcomes Research, and Director of the Veteran's Affairs Health Sciences Research and Development Center of Excellence on Implementing Evidence-based Practice.

Each hospital system initially tackled MRSA on two intensive care units. Staff teams are working to refined processes on these units so that every patient admitted is cultured and MRSA positive patients are placed in isolation to prevent spread of the infection to others.

Using the internationally respected Regenstrief Institute developed Indiana Network for Patient Care, which electronically links emergency rooms throughout Central Indiana, the IU, VA and Regenstrief Institute, Inc. researchers have engineered a system that allows the participating hospitals to communicate, share and track MRSA infections. This data provides infection control officers and clinicians with the identification of patients with a known history of drug-resistant infections when they first contact a new institution, critical to stopping the spread of the superbug.

Aggressive hand washing procedures for all health care providers have been put in place throughout the participating hospitals and these procedures are continually evolving. From the beginning of this initiative, staff at all levels have been engaged in the infection control process, identifying barriers and offering suggestions which may be especially significant for their site.

With health information exchange spanning more than 95% of all inpatient care in the city, no other urban healthcare environment is as wired as that of Indianapolis, the nation's 12th largest city. Using uniquely available information plus reengineered and staff designed and implemented processes to change the system to improve hygiene to combat MRSA, the IU, VA and Regenstrief Institute researchers are making important strides to transform the health care system. This exciting partnership is working to ensure the safety and quality of healthcare for a growing urban area and developing a model from which they believe other cities around the world will want to learn.