Electronic Surveillance Systems in Infection Prevention: Organizational Support, Program Characteristics, and User Satisfaction

Background: The use of electronic surveillance systems (ESS) is gradually increasing in infection prevention and control programs; however, little is known about the characteristics of hospitals that have ESS, user satisfaction with ESS, and organizational support for implementation of ESS.

Objective: The goal of this study was to compare the differences in where and how infection preventionists (IPs) spend their time in hospitals with and without ESS, describe characteristics of hospitals with and without ESS, and assess IP satisfaction with ESS.

Methods: Three hundred and fifty acute care hospitals in California were invited to participate in a web based survey conducted in Fall of 2008. The survey included a description of infection prevention and control department staff, where and how they spent their time, a measure of organizational support for infection prevention and control, and reported experience with ESS. Descriptive statistics were computed on all variables. Bivariate analyses were conducted initially using appropriate parametric and nonparametric statistics. Variables which were statistically significant in bivariate analyses were entered into logistic regression models.

Results: 207 hospitals agreed to participate (response rate 59%). Only 23% (44/192) of responding infection prevention and control departments had an ESS. ESS was primarily used to create reports and data summaries from built-in templates (77%), sharing reports with committees and administration (61%), automatic alerts (57%), integration of infection data with CDC definitions and/or reporting requirements (43%), and data mining (36%). The largest proportion of time spent by IPs in hospitals with or without ESS was in surveillance, policy development and meetings, and consultation. There were no statistically significant differences in how and where infection preventionists (IPs) who used ESS and those who did not spend their time. The two significant predictors of whether an ESS was present were score on an Organizational Support Scale (OR: 1.10, 95% CI 1.02-1.18) and hospital bed size (OR: 1.004, 95% CI 1.00-1.007). Organizational support was also positively correlated with IP satisfaction with ESS as measured on a Computer Usability Scale (p=.02). Years of experience of the infection control director, total number of hours ESS was used daily, and total number of years since ESS was implemented were not significantly associated with level of satisfaction.

Conclusions: ESS are still relatively uncommon in infection prevention and control programs, despite evidence that such systems may improve efficiency of data collection and potentially improve patient outcomes. Based on this study, organizational support appears to be a major predictor of the presence, use and satisfaction with ESS in infection prevention and control programs.