Archived Results at a glance - Evaluation of Healthcare-Associated Infection Activities

March 2018

Introduction

• The World Health Organization defines healthcare-associated infections as infections occurring in a patient during the process of care in a hospital or other healthcare facility, which were not present or incubating at the time of admission.
• PHAC’s healthcare-associated infections activities aim to reduce and prevent health risks related to healthcare-associated infections. Overall, these activities can be categorized into three broad groups: surveillance, advice/guidance and outbreak response assistance.
• Total expenditures for these activities approximate $3.4M per year.
• PHAC tracks and monitors healthcare-associated infections in Canada using the Canadian Nosocomial Infection Surveillance Program (CNISP). Data on cases of healthcare-associated infections are submitted by 65 acute-care hospitals around the country and analysed by PHAC.
• PHAC also tracks and monitors antimicrobial resistance (AMR) through the Canadian Antimicrobial Resistance Surveillance System (CARSS). It works with scientific experts and health professionals in Canada and around the world to monitor trends and impacts.

What the evaluation found

• There is a continued need for PHAC’s healthcare-associated infections activities as these infections remain persistent in Canada but are often preventable. These infections result in increased morbidity/mortality and a significant financial burden to the society. There is also a need to prepare for and support responses to emerging healthcare-associated infections. 
• PHAC has a clear role in bringing together provinces and territories, providing national surveillance data and guidance, and maintaining international links in this area. This role is generally well understood by stakeholders and generally complementary with the role of provinces and territories and other national organizations. There is a potential for duplication of efforts in surveillance as PHAC and provinces are not necessarily using common case definitions for their surveillance systems.
• There is evidence that stakeholders use PHAC’s healthcare-associated infections surveillance and guidance knowledge products to improve practices, although older guidance products are mostly used. Potential use of PHAC products is limited by a lack of up-to-date information, a lack of timely products and a lack of surveillance data on community, rural and northern hospitals.

Recommendations and responses

1. Clearly articulate PHAC’s role and priorities for HAI activities and communicate those to stakeholders.
   Response: Management will organize a facilitated workshop to engage PHAC program and policy areas involved in healthcare-associated infection surveillance, guidance and laboratory activities on: PHAC’s role and priorities for healthcare-associated infection activities, how to improve effectiveness and efficiencies, and how to communicate these roles and priorities to stakeholders.
2. Explore options to improve program effectiveness and efficiency focusing on improving: a) the timeliness of surveillance and guidance knowledge products and b) the coverage of CNISP surveillance data.
   Response: Include discussions and analyses on efficiencies and effectiveness in the facilitated workshop discussed under recommendation 1 above.

About the evaluation

This was the first time PHAC’s healthcare-associated infection activities were evaluated. The evaluation examined the relevance and performance of those activities. Methods used to collect data to address the evaluation questions included a review of the literature, media articles, program documents and financial data, as well as a citation analysis and key informant interviews.