1. EVALUATING THE FINANCIAL IMPACT UPON A CRITICAL CARE UNIT OF REDUCING THE RATE OF HEALTHCARE ASSOCIATED INFECTIONS (HCAI)
Hugues Hallot
Dr Mark Smithies
Dr Eleri Davies
Mike Davidge
Chris Hancock
Martyn Read

2. Project Aims
To develop a methodology for determining the full financial impact of CVC infections upon critical care hospital resources.
To use this methodology to accurately determine the saving that has been incurred at the critical care department at UHW as a result of the patient safety work.

3. Method
Identification of infected and uninfected patient groups (52 patients with bacteraemia)
Stratification with indirect standardization for age and APACHE II
Comparison of LoS between the groups
Calculate cost of LoS, drugs and testing as cost of 1 CVC infection
Calculate difference in infection rate to determine overall savings
Stratification with indirect standardization : stratums are created using for that the combination of the classes dividing each criterion (Presence of infection, Age and APACHE II score on first day of admission).
Creation of group of patients : determination of the class depending of the repartition of the patients and the medical significance.
For each group : LoS, difference (I/NI).
Weighted mean : by the number of infected patients in each group.
Project Presentation
18/09/2009 3

4. Cost of 1 Infection Additional length of stay : 17.81 days
Bed day cost : £1596
Cost of the additional LOS : £28,
Drugs costs :
Mean drug cost : £ (Welsh contract prices).
Mean test costs : £27.99.
Total cost of 1 infection : £28,563.61

5. Results 5 Project Presentation 18/09/2009 5 5
Point of comparison : Institute for Healthcare Improvement (IHI, an independent not-for-profit organization based in United States) : 5.3 I per 1,000 Cds
Program : late spring 2006, no immediate effect.
Augmentation in : Lag in the effects of the program? (2007 : concentrated on the first half of the year)
show diminution compared to
2005 : exceptional year?
2008+ : important reduction (2005 suspected to be particular). 5
Project Presentation
18/09/2009 5 5

6. Savings 2008 Reduction of 0.34 infection per 100 patients.
Reduction of 3.66 infections for 2008.
Savings 2008 : 4 x £28, = £114,254.40
Extra bed days available: 64
Decreasing use of Central line
Bed days available : ICU bed free for other patients thank to the avoided infections.
Overall savings : counting the cost of the program in 2006 and 2007.
Because : Lag in the reduction?
Savings 2008 : number of infection avoided with the number of ICU patients in 2008.
Decreasing use of Central line : cost not evaluated.
Project Presentation
18/09/2009 6

7. Conclusion Identifiable cost savings
Increased unit efficiency (reduction in cancelled ops etc)
Reproducible method