Translation Prevention Research Epicenter
First Funded: 1997
Overview: The Eastern Massachusetts Prevention Epicenter is led by the Department of Population Medicine at Harvard Medical School and Harvard Pilgrim healthcare. The Eastern Massachusetts Epicenter is composed of multiple healthcare facilities, including Brigham & Women's Hospital; Massachusetts General Hospital; and North Shore Medical Center & Children's Hospital, Boston. Each of these entities is enabled with common informatics infrastructures well-suited to support healthcare quality research.
Research Study Areas:
- Surgical Site infection surveillance. The goal is to develop more efficient, reliable, and meaningful definitions and surveillance methods.
- Use of Medicare claims to identify hospitals with high rates of surgical site infection.
- Development and evaluation of novel surveillance methods in the inpatient setting. The use of postoperative antibiotic exposure is a particular focus of this work.
- Antimicrobial resistance:
- Assessing MRSA and VRE colonization pressure and invasiveness in ICUs.
- The Randomized Evaluation of Decolonization Versus Universal Clearance to Eliminate MRSA (REDUCE MRSA project), which is a cluster randomized trial designed to assess the comparative effectiveness of three principal strategies for the prevention of MRSA+ clinical cultures in intensive care units. This study is a collaborative effort of the CDC Prevention Epicenters, Agency for Healthcare Research and Quality (AHRQ), and the Hospital Corporation of America.
- Cost-effectiveness analysis of healthcare-associated infection prevention strategies. This work incorporates a decision analysis framework to clarify trade-offs in the adoption of one set of infection control recommendations versus another in the setting of constrained resources.
Research Project Examples:
- The surgical site infection surveillance work with the Centers for Medicare & Medicaid Services (CMS) has demonstrated that inpatient and outpatient Medicare claims can identify hospitals with unusually high or low post-coronary artery bypass graft (CABG) SSI rates. Claims are more sensitive, reproducible, and efficient than current surveillance methods and can identify hospitals that may benefit from prevention programs. The success of the work to date suggests it may be worthwhile to extend this approach to the other SCIP procedures.
- The REDUCE–MRSA Project is a cluster randomized trial of 45 hospitals in the Hospital Corporation of America (HCA) network. Hospitals have been randomized to one of three strategies for the prevention of MRSA+ clinical cultures in intensive care units: a) screening followed by isolation of MRSA+ patients, b) screening followed by isolation and decolonization of MRSA+ patients with chlorhexidine baths and nasal mupirocin, c) universal decolonization without screening.
Richard Platt, MD, MS
Professor and Chair
Department of Population Medicine
Harvard Medical School