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AHRQ--Agency for Healthcare Research and Quality: Advancing Excellence in Health Care

Topic Suggestion Description

View Topic Suggestion Disposition (PDF) 42 kB

Date submitted: June 21, 2012

Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.
For all hospitalized patients, does a specially formulated and delivered "bundle" of infection control processes reduce the risk of hospital acquired infections and reduce all associated costs?
Does your question include a comparison of different health care approaches? (If no, your topic will still be considered.)
If yes, explain the specific technologies, devices, drugs, or interventions you would like to see compared:
Current or status quo infection control processes and the specially formulated and delivered "bundle".
What patients or group(s) of patients does your question apply to? (Please include specific details such as age range, gender, coexisting diagnoses, and indications for therapy.)
All in-patients.
Are there subgroups of patients that your question might apply to? (For example, an ethnic group, stage or severity of a disease.)
Subgroups include the frail elderly, those with exposure to nursing home or ESRD settings, and Medicaid.
Describe the health-related benefits you are interested in. (For example, improvements in patient symptoms or problems from treatment or diagnosis.)
Avoidance of HAI.
Describe any health-related risks, side effects, or harms that you are concerned about.
No risks have been found associated with using this care bundle.

Appropriateness for EHC Program

Does your question include a health care drug, intervention, device, or technology available (or likely to be available) in the U.S.?
Which priority area(s) and population(s) does this topic apply to? (check all that apply)
EHC Priority Conditions (updated in 2008)
  • Infectious diseases, including HIV/AIDS
AHRQ Priority Populations
  • Low income groups
  • Minority groups
  • Elderly
  • Individuals with special health care needs, including individuals with disabilities or who need chronic care or end-of-life health care
Federal Health Care Program
  • Medicaid
  • Medicare


Describe why this topic is important.
If this infection control bundle potentially has the capability of reducing HAIs to near zero with tremendous cost savings, while training healthcare workers in new and transferable skills.
What specifically motivated you to ask this question? (For example, you are developing a clinical guideline, working with a policy with large uncertainty about the appropriate approach, costly intervention, new research you have read, items in the media you may have seen, a clinical practice dilemma you know of, etc.)
Unfortunately many healthcare facilities and systems seem reluctant to make changes in this field, eg, patient safety advancements, without substantially more nationally recognized evidence.
Does your question represent uncertainty for clinicians and/or policy-makers? (For example, variations in clinical care, controversy in what constitutes appropriate clinical care, or a policy decision.)
If yes, please explain:
There seems to be a need, as found in the literature, to examine what works in infection control to a greater extent, such as through scientific studies.

Potential Impact

How will an answer to your research question be used or help inform decisions for you or your group?
It would be beneficial to test the bundle and begin to parse out and examine the effect of each element. Elements of the bundle include environmental cleaning methods, isolation, nursing activities, product review and choice, team training, quality improvement methods, patient cleaning, patient activation, infection control activities, senior leadership activities, education, measures and reporting, analysis, and peer-mentoring. By confirming the full model it can be promoted to a greater extent.
Describe the timeframe in which an answer to your question is needed.
The vast improvement to infection control, retraining and cost reductions that this model offers is needed now.
Describe any health disparities, inequities, or impact on vulnerable populations your question applies to.
This type of program will lessen the risk of HAIs which can pose a greater threat to the frail, elderly, patients that use antibiotics, and have pressure ulcers or invasive procedures.

Nominator Information

Other Information About You: (optional)
Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate)
  • Continuous Quality Improvement Group
Are you making a suggestion as an individual or on behalf of an organization?
Please tell us how you heard about the Effective Health Care Program