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A Simulation Model to Compare Strategies for the Reduction of Health-Care–Associated Infections

Reidar Hagtvedt, Paul Griffin, Pnar Keskinocak, Rebecca Roberts

University of Alberta School of Business, Edmonton, Alberta T6G 2R6, Canada
School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, Georgia 30332
School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, Georgia 30332
Department of Emergency Medicine, Cook County Hospital, Chicago, Illinois 60612
hagtvedt{at}ualberta.ca
pgriffin{at}isye.gatech.edu
pinar{at}isye.gatech.edu
rroberts{at}ccbh.org

Cook County Hospital, like many hospitals in the United States and worldwide, is pursuing a strategy to combat health-care–associated infections (HAIs). In the United States, approximately two million people are infected each year and over 100,000 die. In this paper, an interdisciplinary team of researchers from Georgia Tech and Cook County Hospital, with backgrounds in engineering, economics, and medicine, analyze the flow of pathogens. We combine infection rates and cost data to build a discrete-event simulation model to capture the complex relationships between hand hygiene, isolation, demand, and costs. We find that both hand hygiene and isolation policies have a significant impact on rates of infection, and that a complex interplay between factors exists. This suggests that a systems-level approach to infection-control procedures will be required to contain health-care–associated infections.

Key Words: health care; health-care–associated infections; discrete-event simulation