This is a competingrenewalapplicationfor the EasternMassachusettsPreventionEpicenter,whichincludes 16 health care institutionst:hestate'stwo largesthealthplans,caringfor over halfthe state'spopulation;six adultacademic referralcenters;a cancer hospital;a pediatricacademic healthcenter;five community hospitals;and a rehabilitationfacility.The Epicenterwill pursuefouraims that buildon itswork of the past eightyears. These includedevelopingsurrogatemarkersfor surveillanceof healthcare-associatedinfections andotheradverseevents,and assessmentand preventionof antimicrobialresistance.We will 1) Test a claims-basedalgorithmwe developedfor identifyinghospitalswith highratesof surgicalsiteinfection(SSI) follm,ing,,c,o_ronary artery bypassgrafting(CABG). We willworkwith the Centerfor Medicareand Medicaid Services(CMS) andthe OklahomaQIO SupportCenter toevaluate>800 hospitalsand >200,000 CABG }rocedures.If successful,this approachwill allow efficientand uniformassessmentof essentiallyall losp_talsperformingthis procedure,permittingefficienttargetingof quality improvementactivities.It willalso setthe stage for claimsbased SSI surveillancefor otherprocedures.2) Developsurrogatemeasuresto supportinpatientsurveillancefor SSI followingtheSurgicalCare ImprovementProject(SCIP) procedures.
This aim extendsour longstandingwork showingtheutilityof quantitativeantibioticexposureas a marker for SS!foIlo;,,'ingCABG, breastsurgery,and cesareandelivery.3) Evaluatethe abilityof automatedstanding ordersin an electronicorderentrysystemtosustainstaffcompliancewitha successfulMRSA prevention program.This work buildson a demonstrationprogramthatwas effectivebutdependedon dailyhighlevel infectioncontrol clinicianparticipation4. ) Assess the utilityof administrativeclaimsdatato identifyadditional adverseevents, includingnon-infectiouscomplicationsof surgery.We willespeciallyemphasize identificationof post-dischargemorbidity.These eventswill includemyocardialinfarction,deepvein thrombosis,and C. difficileassociateddisease. We willfocusonproceduresand outcomesthat are part of the currentNational SurgicalQualityImprovementProgramand SCIP initiatives.We will performeconomic analysesfor all of these programs.The Epicenterwillcontinueparticipatingin multi-Epicenterinitiatives,and it willcontinueto respondtoCDC's interestsandneeds inaddressingnew problems._R.U.A.NCE S/TE(S) (ce'_.'_aSon. dry. state)Beth Israel Deaconess MedicalCenter (BIDMC), Boston,MABlueCrossrBlueShield of Massachusetts(BCBS/MA),Boston,MABostonMedicalCenter (BMC),Boston,MABrigham&Women's Hospital(BWH), Boston,MACenterfor Medicare and MedicaidServices (CMS), Baltimore,MDChildren'sHospital, Boston(CHB), MADana Farber Caner Institute,Boston(DFCI), MAFaulknerHospital, Boston,MA HarvardMedical School(HMS) Departmentof AmbulatoryCare andPrevention(DACP), Boston,MA HarvardPilgrim Healthcare (HPHC), Boston,MA LaheyClinic, Burlington,MA Massachusetts General Hospital (MGH), Boston, MA NewEngland Medical Center (NEMC), Boston, MA Newton-Wellesley Hospital, Newton, MA Salem Hospital, Salem, I%_k Spaulding Rehabilitation Hospital, Boston, MA Oklahoma Foundation for Medical Quality (QIOSC), Oklahoma City, OK Union Hospital, Lynn, MAPH3 3_3 (Rev. 0c.'04) Page 2 Form Page 2 Pf.'-_pal I,_o'es_gatodPr_jramDirector(last, First,Middle): Platt, Richard PER.SO.N;;=_LSee L'_._(_LS. Use continuab'onpages as needed to provide the requiredinformation in the format shown below.S.'_..v'I,_ P_n_] I?,'es_gaL,_'.List a_lother key personnel in alphabetical order, last name first.t_.,_e eRA CommonsUser Name Organization Role on ProjectPlait, Richard, MD, MS HPHC, BWH, HMS PrincipalInvestigatorHuang,Susan, MD, MPH BWH Co-investigatorKleinman,Ken, ScD HPHC, HMS Co-investigatorProsser, Usa, PhD HPHC, HMS Co-investigatorYokoe, Deborah, MD, MPH BWH, DFCI Co-investigatorOTH=.=.S=I.G=.='_.=R.C=.A=.N=_TRCO,NTPJBUTORSl_' Organization Role on ProjectBratzler, Dale, DO, MPH QIOSC CollaboratorGustafson, Michael, MD, MBA BWH, Faulkner CollaboratorHunt, David, MD, FCAS CMS CollaboratorRogers, Sek'6n'l,MD, MPH BWH CollaboratorHuman Embryonic Stem Cells [] No [] YesIf L--_e-c-pcsedpcojectInvolveshuman embryonicstem cells,list below the reglsb'atJonumberof thespecificcellline(s) fromthe followinglist:h_:h'stemcetls.nih.oov/'reaistry/index.asD. Use onb'nuationpages asneeded.ffa soec_ L'-Je m.-v'xb_erefere,,x:_,adt thistSmei.ncludea statementhatonefromtheRegistryvailbe used.CellUneDisclosure Pe.'Tnission StatemenL App_cabTeto SBIFUS'I-rROnly. See SBIR/STTR instructions. [] Yes [] NoPHS 3._3(Re./. 0_'04) Page3 Form Page 2-continuedNumbetrhefoflowingpagesconsecuSvethlyroughouttheappScatJoDno.notusesuffixesuchas4a,4b. Pf.-._pal I.,_'es'C_atcr,'Prog,'aDmirector(Last,First, MiddIe): Platt, Richard The r.a..'n.cef L_,ep,_,'_dpaLlw, es'C_jatorlprogramdirector must be provided at the top of each printed page and eachcontinuation page. RESEARCH GRANT TABLE OF CONTENTS Page NumbersFace Page................................................................................................................................................. 1Description,

National Institute of Health (NIH)
National Center for Infectious Diseases (CID)
Research Project--Cooperative Agreements (U01)
Project #
Application #
Study Section
Special Emphasis Panel (ZCI1-TYM (10))
Program Officer
Llata, Eloisa
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Harvard Pilgrim Health Care, Inc.
United States
Zip Code
Hayden, Mary K; Lolans, Karen; Haffenreffer, Katherine et al. (2016) Chlorhexidine and Mupirocin Susceptibility of Methicillin-Resistant Staphylococcus aureus Isolates in the REDUCE-MRSA Trial. J Clin Microbiol 54:2735-2742
Huang, Susan S; Septimus, Edward; Hayden, Mary K et al. (2016) Effect of body surface decolonisation on bacteriuria and candiduria in intensive care units: an analysis of a cluster-randomised trial. Lancet Infect Dis 16:70-79
Rhee, Chanu; Huang, Susan S; BerrĂ­os-Torres, Sandra I et al. (2015) Surgical site infection surveillance following ambulatory surgery. Infect Control Hosp Epidemiol 36:225-8
Huang, Susan S; Septimus, Edward; Avery, Taliser R et al. (2014) Cost savings of universal decolonization to prevent intensive care unit infection: implications of the REDUCE MRSA trial. Infect Control Hosp Epidemiol 35 Suppl 3:S23-31
Septimus, Edward J; Hayden, Mary K; Kleinman, Ken et al. (2014) Does chlorhexidine bathing in adult intensive care units reduce blood culture contamination? A pragmatic cluster-randomized trial. Infect Control Hosp Epidemiol 35 Suppl 3:S17-22
Calderwood, Michael S; Kleinman, Ken; Bratzler, Dale W et al. (2014) Medicare claims can be used to identify US hospitals with higher rates of surgical site infection following vascular surgery. Med Care 52:918-25
Huang, Susan S; Septimus, Edward; Kleinman, Ken et al. (2013) Targeted versus universal decolonization to prevent ICU infection. N Engl J Med 368:2255-65
Yokoe, Deborah S; Avery, Taliser R; Platt, Richard et al. (2013) Reporting surgical site infections following total hip and knee arthroplasty: impact of limiting surveillance to the operative hospital. Clin Infect Dis 57:1282-8
Moody, Julia; Septimus, Edward; Hickok, Jason et al. (2013) Infection prevention practices in adult intensive care units in a large community hospital system after implementing strategies to reduce health care-associated, methicillin-resistant Staphylococcus aureus infections. Am J Infect Control 41:126-30
Avery, Taliser R; Kleinman, Ken P; Klompas, Michael et al. (2012) Inclusion of 30-day postdischarge detection triples the incidence of hospital-onset methicillin-resistant Staphylococcus aureus. Infect Control Hosp Epidemiol 33:114-21

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