The Hospital

RDB serves both patients and hospitals to protect the patient through the entire operative experience, before, during, and after surgery.

Hand Hygiene: Hospitals need to provide equipment designed for the fast-paced environment so that providers can wash their hands for the 300+ opportunities per hour. Hospitals need to provide monitoring of OR hand hygiene compliance which will allow individual and group level feedback regarding hand transmission to optimize compliance. The impact of hand hygiene efforts on reducing high risk stopcock contamination should be monitored.

Intravascular Device Design and Handling: Most hospitals are still using high-risk, open lumen devices, most hospitals using DNCCs are not using evidence-based hub disinfection systems, insertion carts and check lists are not routinely used in the OR for central line insertion, hub and syringe disinfection compliance is not monitored.

Environmental Cleaning: Routine and terminal cleaning efforts are proven to be ineffective and to serve as institutional reservoirs for ongoing transmission, including transmission of high-risk pathogens to intravascular devices. Most institutions fail to leverage surveillance of OR contamination/transmission to optimize this key preventive measure. Products and techniques that are proven to reduce environmental contamination during patient care are not routinely employed.

Shown in the figure below is a typical OR transmission pattern for a superbug, S. aureus MLST 8 (USA 300, a common cause of invasive, community-associated, methicillin-resistant, S. aureus infections with an associated mortality rate of 18%), due to the above gaps. The organism’s path is typically on the hands of attending anesthesiologists at the start of the case (AHO1, poor hand hygiene) and transferred to the first patient of the day (PA1, poor hand hygiene leads to patient contamination). It remains on the hands of the attending physicians throughout the case (AHE1) and carried on the next case of the day in the same OR room (AH02, poor hand hygiene). It is then transmitted to the second patient of the day (PA2) and remains on the hands at the end of the second case (AHE2). It is left behind in the environment at case end (TE2A), and gets injected into the second patient’s stopcock set (LE2). (Data produced by OR PathTrac Surveillance, on file with RDB Bioinformatics, Omaha, NE 68154).

Track Your Bacterial Transmission

Add the ability to measure success and quantify results

There are significant gaps in OR Hygiene practices that can and should be addressed, supporting ongoing CMS penalties (https://khn.org/news/medicare-penalizes-group-of-751-hospitals-for-patient-injuries/). RDB Bioinformatics’s mission is to work with patients, healthcare providers, acute care settings, and the medical community to address the 3 goals put forth by the CDC so that we can maximize patient safety today and for the future, preventing high risk OR bacterial transmission.

RDB offers a comprehensive surveillance program that can track ESKAPE spread in order to optimize basic preventive measures. This system will help any hospital system to identify gaps in basic practices and provide and optimize methods of improvement. As your transmission prevention partners, we provide easy to use collection kits that measure seven processes of patient care. You send the collected specimens back to RDB for processing using the kits and instructions provided. RDB performs all complex microbiological, statistical, and computational analysis required to provide you with an easy to use reporting platform to identify gaps, identify actionable items, identify evidence-based improvement strategies, provide individual and group level feedback, and continual fidelity measurement. The RDB team works alongside you to maximally optimize OR hygiene, focusing your attention of creating a culture of patient safety and addressing CDC directives to reduce surgical site infections, especially bloodstream infections, to prevent the spread of bacteria between patients, and to improve antibiotic stewardship. Our future depends on your compliance with optimizing these measures.

Gaps exist in:

  • OR hand hygiene
  • intravascular catheter care and design
  • environmental cleaning
  • patient decolonization

RDB Bioinformatics provides a unique platform for preoperative patient decolonization and optimization of OR basic infection prevention practices (OR Hygiene) through the OR PathTrac surveillance system.

The Hospital: Home PathTrac

Helping Hospitals to Decolonize Patients Before Surgery

Why do you want to use the Home PathTrac service?

Cost

Your hospital is already screening and treating patients before surgery. RDB Home PathTrac services cost less than the average cost of screening and treatment Home PathTrac for your patients is less than your current cost, saving you millions in hard costs. This savings prior to surgery alone is unprecedented in the industry.

Simple

The RDB Home PathTrac system is simple and straightforward. The RDB team focuses on workflow process, efficiency, and efficacy during the planning stages to ensure the system implements in your environment without hurdles.

  • The system contains several key steps:
  • RDB microEMR entry system used to track and associate patients results to the OR
  • HIPAA compliant. RDB Bioinformatics data storage is safe and secure.
  • No software or IT integration required
  • The Home PathTrac kit requires a few simple fields in the microEMR, give the kit to the patient, or RDB sends to the patient, RDB takes care of the screening and treatment process in cooperation with your doctors.

Streamlined

Part of our team planning includes requiring little effort from the hospital labor. Our goal is to reduce hospital labor and improve the employee satisfaction of the patient screening and treatment arena.

Standardized, Cost-effective

Continuing the standardized process, the RDB Home PathTrac system assists in cost-reduction and increase ROI in variety of ways. Not only in average hospital during, opportunity costs, legal fees, etc, but also:

  • Reduced reporting
  • Reduced risk of lost reimbursement
  • Improved patient satisfaction
  • Improved public relations image
  • Easy mechanism for MIPPs compliance

Home PathTrac addresses the patient prior to surgery and shows savings in both hard costs and direct/indirect costs of infections. It also generates a tremendous return that in the end pays for OR PathTrac and the associated benefits of that related system.

The Hospital: OR PathTrac

Helping Hospitals to Optimize Perioperative Infection Prevention

Why do you want to use the OR PathTrac System?

Identify Gaps

OR PathTrac identifies gaps in the existing basic infection prevention practices such as hand washing, environmental cleaning, vascular care, and patient decolonization. In addition to identifying gaps and showing what is NOT working, the system confirms what IS working in your environment. While identifying problems are important, detailing efforts that are successful are equally important. The RDB OR Pathtrac system provides the data to quantify those efforts.

Map Bacterial Transmission of Superbugs

The timeline map of bacterial transmission is critical in displaying the transmission pathways common to the surperbugs specific to your environment. With the transmission map, we provide evidence-based steps for the improvement lifecycle. The core of the PathTrac system is mapping the pathways. Combined the Home Pathtrac and WES after surgery, OR PathTrac is the center of the transmission pathway.

Continually Measure Fidelity

The first baseline measurement is to show a baseline of transmissions in your OR. After the baseline, the system continually monitors and measures the fidelity of your interventions and the RDB team of experts help you optimize your efforts. We are your infection control partners.

The RDB OR PathTrac system provides your map of OR superbug exposure, which guides your strategic use of the limited resources you already own, such as the robotic cleaning units. Determining which OR to deploy the unit to is probably more important than owning the unit altogether. Only deploy the robotic cleaning unit to the ORs which have the highest MRSA exposure in the last month, for example.

For provider education, the OR PathTrac system identifies which group have a higher transmission rate. If we determine these transmissions orginate from provider hands, then concentrate on education for that group specifically, again continuing the theme of maximizing and quantifying your efforts to gain the best results possible.

Identify Your Superbugs

Planning ahead and having an action plan ready in case the worst happens is important. Having an action plan in place to address an outbreak is important. Identify and map your superbugs so that you can have an action plan in place to address them in the case of an outbreak.

When you identify your superbugs, you also have an opportunity to work with RDB to build rapid, cost-effective diagnostics to optimize safety for patients undergoing elective, urgent, and even emergent surgery.

Encourage Good Stewardship of Antibiotics

Ongoing perioperative surveillance provides a platform to identify the best overall antibiotic across your service lines. By analyzing the traits of the superbugs found in your environment, we report on the best antibiotic for your institution to avoid fueling emerging resistance, and to improve antibiotic stewardship.

When infections occur, the OR Pathtrac system can determine the causative organism, and determine the ID of the organism, the common source of the transmission, and the method of spread to result in detailed action plans, and improved antibiotic choices.

Postoperative Monitoring

Continuing the surveillance process from the patient prior to surgery, through the OR and onto the postoperative arena, we provide a method to optimize basic prevention measures in the postoperative period including the hospital floor, critical care, post anesthesia care unit, and same day environments. The RDB Bioinformatics system links this data to the previous to complete the bacterial transmission pathway.

Public Display of Commitment to Patient Safety

Patient safety is important, and patients want to know the system they trust is working in their best interest. Under the umbrella of quality improvement, use the OR PathTrac system to show patients and payers that you are doing everything you can at your hospital system to optimize patient safety throughout their perioperative experience.

Be an Industry Leader

RDB Bioinformatics is looking for industry leader partners to work with creating a national registry through OR PathTrac. Position your hospital or hospital system as a world leader in addressing the persistent nature of heathcare-associated infections in the post antibiotic era by being selected as part of the registry. The registry will serve as the platform for future understand transmissions, antibiotic resistance, development of new diagnostics, and the development of new antibiotics and disinfection agents.

In addition to the national registry, OR PathTrac works as an innovative research platform for your institution to fuel ongoing publications and serving as a platform for innovation.

Read the Whitepaper

Dr. Randy Loftus published a white paper specifically for the purpose of discussing the details of the RDB Pathtrac system, both the problem and the solution.

Download the white paper to get full details of the program.

Watch the Talk

Dr. Loftus gave a talk in October 2017 at APIC. Watch his presentation giving background on our system.

Improving Intravascular Device Disinfection in Today’s Operating Rooms

Presented at the APIC 2017 conference by Randy Loftus, MD, Associate Professor, Anesthesiology and B. Braun.

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