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About the Collaborative Healthcare-Associated Infection Network (CHAIN)

Healthcare providers are taking action to reduce HAIs

Healthcare-associated infections (HAI) are infections caused by a wide variety of common and unusual bacteria, fungi, and viruses during the course of receiving medical care. Medical advances have brought lifesaving care to patients in need, yet many of those advances come with a risk of HAI. These infections related to medical care can be devastating and even deadly. As our ability to prevent HAIs grows, these infections are increasingly unacceptable.

Recent successes in HAI elimination have been very encouraging. Reductions have been demonstrated for other HAIs as well, but much more remains to be done. Wherever patient care is provided, adherence to infection prevention guidelines is needed to ensure that all care is safe care. This includes traditional hospital settings as well as outpatient surgery centers, long-term care facilities, rehabilitation centers, and community clinics.

Collaborative Healthcare-Associated Infection Network (CHAIN)

The Collaborative Healthcare-Associated Infection Network (CHAIN) develops and helps carry out effective approaches for reducing and preventing healthcare-associated infections in Minnesota. Healthcare-associated infections (HAI) prevention goals are achieved through interventions focused on hand hygiene, transmission precautions, injection practices, antimicrobial stewardship, environmental cleaning and evidence-based clinical bundles. The partnership is focusing on reducing and preventing the following infections:

  • CLABSI: central line associated bloodstream infections
  • CAUTI: catheter associated urinary tract infections
  • CDI, C. diff: clostridium difficile infections
  • SSI: surgical site infections

This work aligns with the work of other groups focusing on patient safety, adverse event reporting, transforming care at the bedside, and quality reporting and improvement. The initial focus for prevention is on infections occurring in the hospital setting.

APIC-MN, the Minnesota Department of Health, the Minnesota Hospital Association, and Stratis Health formed CHAIN in 2011.

APIC logo MDH logo Stratis Health logo

Targeted Settings for Infection Reduction

Initially targeted to hospitals, the project will extend to ambulatory surgery centers, long-term acute care rehabilitation facilities, clinics, nursing homes, home care agencies, and HDC. This work will be aligned with the work of other groups focusing on patient safety, reportable events, transitional care at the bedside, quality reporting and improvement, and improving preventive health by achieving meaningful use of electronic health record systems.

Minnesota Statewide HAI Plan

HAI are a serious patient safety issue, and reducing HAIs is a national priority. In 2009, the U.S. Department of Health and Human Services developed an action plan with national goals for reducing HAIs, and provided funds through the American Recovery and Reinvestment Act (ARRA) for each state to develop and implement its own HAI Action Plan.

Minnesota formed the HAI Advisory Group to guide the development of the Minnesota HAI Plan with measureable goals and objectives that complement existing Minnesota HAI prevention efforts to ensure Minnesota's progress toward national HAI prevention targets.

The Minnesota HAI Advisory Group includes representatives from key organizations involved in HAI prevention: the Association of Professionals in Infection Control – Minnesota (APICMN), the Institute for Clinical Systems Improvement (ICSI), Minnesota Antibiotic Resistance Collaborative (MARC), the Minnesota Department of Health Policy, Quality, and Compliance Bureau, the Minnesota Department of Health Protection Bureau, the Minnesota Hospital Association, the Minnesota Medical Association (MMA), the North Central Chapter of the Infectious Disease Society of America (NCCIDSA), Stratis Health, and consumer representatives.

CHAIN Partners

Association for Professionals in Infection Control and Epidemiology, Inc. (APIC) aims to improve health and patient safety by reducing risks of infection and other adverse outcomes. Its more than 13,000 members have primary responsibility for infection prevention, control and hospital epidemiology in health care settings around the globe. APIC's members include nurses, epidemiologists, physicians, quality and patient safety professionals, health care executives, microbiologists, clinical pathologists, laboratory technologists, and public health practitioners. APIC advances its mission through education, research, consultation, collaboration, public policy, practice guidance and credentialing.

Minnesota Department of Health.MDH, Acute Disease Investigation and Control Section convened the Minnesota HAI Prevention Advisory Group, a multi-disciplinary advisory group, which provided leadership to implementation of the statewide HAI Prevention Plan, identify led two collaboratives aimed at preventing CDI and SSI, and identified two statewide surveillance measures.

Minnesota Hospital Association. MHA is a trade association representing Minnesota’s hospitals and health systems.

Stratis Health is an independent nonprofit organization that leads collaboration and innovation in health care quality and safety, and serves as a trusted expert in facilitating improvement for people and communities. Under its work as the Medicare Quality Improvement Organization for Minnesota, Stratis Health is working to reduce HAIs to improve individual patient care.

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CHAIN is an effort lead by the Association for Professionals in Infection Control and Epidemiology-Minnesota (APIC MN), Minnesota Department of Health, Minnesota Hospital Association, and Stratis Health, which represents Lake Superior Quality Innovation Network in Minnesota.