How PIH Health Improved Infection Surveillance and Patient Care With Inovalon

PIH Health, a community hospital in the greater Los Angeles area, used to manage patient infections manually. Infection preventionists (IPs) were reviewing patient census lists every day to view culture results one by one and determine isolation status based on the data – data that they had to print, read, then make a decision on.

This was time-consuming and frustrating, and often left the PIH Health IP team playing catch up. By the time they’d identified a potential infection or outbreak, patients presenting an infection were in need of care and the patients around them were at risk of being exposed.

The hospital needed a better way to manage infections – for their IP team, their nurses and physicians on the floor, and the patients they serve.

Enter: Inovalon’s VigiLanz Infection Prevention™, an infection prevention software that integrated with PIH Health’s electronic health records (EHR) system and transformed their infection prevention practices. The hospital went from fully manual to faster, more accurate infection reporting thanks to the power of connected patient data, analytics, and rules-based AI working together to identify and address infections.

Beyond addressing each infection, PIH Health has greatly improved their reporting accuracy. They’re now more appropriately attributing infections as community-onset versus hospital-acquired infections (HAIs), whereas previously, many community-onset cases weren’t being identified and tested until the hospital-acquired surveillance period of their stay.

The PIH Health IP team noticed an opportunity to reduce their high rate of hospital-onset C.diff. infections (HO-CDI), for which signs and symptoms are diarrhea, elevated white blood count, and inflammation of the colon. However, these signs are often overlooked during admission which is between hospital day 1 to hospital day 3. Stool samples were often collected late, past the present on admission time period, and missed the chance to identify the CDI as community-onset. The missed opportunity also delayed isolation and treatment for the patient.

With VigiLanz Infection Prevention, the hospital identified 50% more community-onset infections – significantly lowering their rate of HAIs.

As Infection Preventionist Peggy Leung R.N., MSN, shared, “The biggest problem we had was CDI. We noticed there were many missed opportunities of the team not catching diarrhea before hospital day 3. Without that early screening, patients were going longer without treatment and the hospital was getting dinged on performance. Now, the custom reporting in VigiLanz Infection Prevention allows the IP team to get alerts when patients are having loose stools before hospital day 3 has ended and remind our nurses to collect stools for testing.”

In addition to catching CDIs sooner, PIH Health has been able to greatly improve their documentation related to infections. With the IP team armed with clear data and reporting trends, they’ve had a stronger basis to engage their physicians and nurses and collaborate on documentation improvements.

The data has helped them show why documentation is so important.

In Leung’s words, “The data has really opened our physicians’ eyes. We can explain to them that the documented diagnosis, signs, or symptoms are being captured by VigiLanz Infection Prevention, and the IP team get alerts on any possible communicable diseases or infections quickly. We’ve been able to raise awareness to our doctors and nurses to spot the signs of infections earlier and properly document them.”

In the case of CDI mentioned above, the reporting not only helped appropriately attribute infections as community-onset, but also, empowered the IP team with data to show hospital leadership the positive ripple effects of earlier identification and appropriate testing. This allowed their partners to lean in and work together to promote early HAI detection by symptom-triggered screening. It further improved awareness of the signs of infection and reporting of those signs, and ultimately, improved patient outcomes and the hospital’s ratings.

Overall, VigiLanz Infection Prevention has opened doors for the PIH Health IP team beyond better reporting and analytics. It’s transformed how the entire organization approaches patient care, documentation, and safety.

“It really helped our providers to see how rules-based, AI-assisted reporting plays a role in early HAI detection. The software has also helped us reinforce the importance of proper documentation, especially if it is a key element of flagging a notification for a possible HAI.”

For example, if the IP team is seeing an increased number of surgical infections, they have the data and analytics to investigate the root cause of the infection and identify a possible trend such as pathogens or types of surgeries. The IP team can then look into gaps such as a specific surgical tool or surgical bundle possibly causing infections. Or it could be patients from one surgeon are presenting infections more than others, or as simple as reinforcing the need for proper handwashing for the whole team.

There are many reasons why an infection may occur, and now with VigiLanz Infection Prevention, Leung and her team are empowered to better understand causes, trends, and the best next step in care – all in a faster, easier way than manual reporting.

In Leung’s words, “This is the vital mentality of what we do. In infection prevention and control, you have to be aware and act on infections. I want to know it sooner and tackle it; that’s much better than being passive and waiting.”