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Data-Driven Interventions for Reducing C. difficile Incidence

Award Number: R01HS027431
ORGANIZATION: AGENCY FOR HEALTH CARE RESEARCH AND QUALITY
OPDIV: AHRQ
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 03/01/2020
PERIOD OF PERFORMANCE END DATE: 12/31/2025

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Data-Driven Interventions for Reducing C. difficile Incidence - Considered one of the most urgent microbial threats by the Centers for Disease Control and Prevention (CDC), estimates of the excess costs of C. difficile infection (CDI) to the healthcare system range from $897 million to over $4 billion. Our long-term goal is to develop tools to identify patients at risk for CDI that could reduce its incidence, decrease transmission, improve patient outcomes, and reduce healthcare expenditures. We have developed and validated an algorithm using the electronic health record (EHR) to identify patients at high risk for CDI several days in advance of their diagnosis. However, there is a gap in knowledge as to whether real- world data-driven risk models can improve outcomes by guiding interventions in a clinical setting. To fill this gap in knowledge and improve CDI prevention efforts in hospitals, we propose the following specific aims: 1) to prospectively deploy an institution-specific daily risk prediction model for CDI and assess how elevated risk relates to colonization with C. difficile; 2a) to conduct a quality improvement study assessing a hospital-wide intervention bundle that incorporates patient risk for CDI; and 2b) to identify heterogeneous intervention effects across different subgroups (e.g., colonized versus not colonized; specific ribotypes) and secondary outcomes (e.g., reduced severity/complications). We will apply our model to daily extracts of EHR data, collect discarded rectal swabs and stool after standard clinical testing is completed to determine colonization status / ribotypes, and assess our model with respect to colonization status, potentially incorporating it to further improve the model. Using rates of hospital-acquired CDI, we will also assess the impact of a hospital-wide, risk-based prevention bundle rolled out for each ward in stepped-wedge, cluster- randomized fashion. The bundle will include both infection prevention and antimicrobial stewardship components. This project’s successful completion would provide a model for improving the prevention of CDI and other healthcare associated infections in hospitals and health centers.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $0 )
2025	2024	REGENTS OF THE UNIVERSITY OF MICHIGAN	1109 GEDDES AVE, SUITE 3300	ANN ARBOR	MI	48109	WASHTENAW	USA	Research on Healthcare Costs, Quality and Outcomes	000	5	11/19/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2024 ( Subtotal = $454,939 )
2024	2024	REGENTS OF THE UNIVERSITY OF MICHIGAN	1109 GEDDES AVE, SUITE 3300	ANN ARBOR	MI	48109	WASHTENAW	USA	Research on Healthcare Costs, Quality and Outcomes	000	5	11/28/2023	NON-COMPETING CONTINUATION	$454,939
														Subtotal = $454,939

Issue Date FY: 2023 ( Subtotal = $469,089 )
2023	2023	REGENTS OF THE UNIVERSITY OF MICHIGAN	503 THOMPSON ST	ANN ARBOR	MI	48109	WASHTENAW	USA	Research on Healthcare Costs, Quality and Outcomes	000	4	11/10/2022	NON-COMPETING CONTINUATION	$469,089
														Subtotal = $469,089

Issue Date FY: 2022 ( Subtotal = $482,796 )
2022	2022	REGENTS OF THE UNIVERSITY OF MICHIGAN	503 THOMPSON ST	ANN ARBOR	MI	48109	WASHTENAW	USA	Research on Healthcare Costs, Quality and Outcomes	000	3	12/15/2021	NON-COMPETING CONTINUATION	$482,796
														Subtotal = $482,796

Issue Date FY: 2021 ( Subtotal = $496,067 )
2021	2021	REGENTS OF THE UNIVERSITY OF MICHIGAN	503 THOMPSON ST	ANN ARBOR	MI	48109	WASHTENAW	USA	Research on Healthcare Costs, Quality and Outcomes	000	2	12/3/2020	NON-COMPETING CONTINUATION	$496,067
														Subtotal = $496,067

Issue Date FY: 2020 ( Subtotal = $500,000 )
2020	2020	REGENTS OF THE UNIVERSITY OF MICHIGAN	503 THOMPSON ST	ANN ARBOR	MI	48109	WASHTENAW	USA	Research on Healthcare Costs, Quality and Outcomes	000	1	2/27/2020	NEW	$500,000
														Subtotal = $500,000

Grand Total All Awards = $2,402,891

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Data-Driven Interventions for Reducing C. difficile Incidence

Award Number: R01HS027431

ORGANIZATION: AGENCY FOR HEALTH CARE RESEARCH AND QUALITY

OPDIV: AHRQ

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 03/01/2020

PERIOD OF PERFORMANCE END DATE: 12/31/2025

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