A novel hospital cleaning bundle that has been shown to improve cleaning thoroughness and reduce vancomycin-resistant enterococci infections by 37% is also cost-effective, according to newly published study results.
Previously, the Researching Effective Approaches to Cleaning in Hospitals (REACH) trial evaluated an environmental cleaning bundle for reducing rates of health care-associated infections (HAIs) in 11 Australian hospitals, explained Nicole M. White, PhD, a research fellow in the Queensland University of Technology, and colleagues.
“The bundle implemented five interventions targeted at improving cleaning practices which emphasized engagement with environmental services staff,” White and colleagues wrote. “Bundle effectiveness was measured by improvements in frequent touch point cleaning and rate reductions in [Clostridioides] difficile infection, Staphylococcus aureus bacteremia (SAB) and vancomycin-resistant enterococci (VRE) infection.
"Investment in new infection control initiatives redirects scarce resources from competing programs. The economic returns of new programs should ideally exceed those for programs that are displaced, and cost-effectiveness analysis is useful for deciding which programs should be supported.”
White and colleagues performed a stepped-wedge cluster randomized trial in 11 Australian hospitals to evaluate the cost-effectiveness of the bundle. According to the study, they defined changes to costs as “the cost of implementing the bundle minus cost savings from fewer infections.” They evaluated cost-effectiveness “using the incremental cost-effectiveness ratio and net monetary benefit of adopting the cleaning bundle over existing hospital cleaning practices.”
Results of the evaluation showed that implementing the cleaning bundle cost, in Australian dollars, $349,000 and generated $147,500 in cost savings. The net monetary benefit of the bundle in preventing infections was $1.02 million and the incremental cost-effectiveness ratio was $4,684 per quality-adjusted life years (QALYs) gained, according to the study.
“Our study has shown that the REACH cleaning bundle is likely to be a cost-effective intervention for reducing HAI burden. Using data collected from a representative mix of Australian hospitals, adopting the bundle cost [Australian]$4,684 per QALY and had greater than an 80% chance of being cost-effective,” the authors concluded. “Pragmatic implementation of the bundle in real-world hospital settings combined with prospective data collection under a stepped-wedge design produced high-quality evidence that the bundle would be cost-effective if implemented elsewhere in similar hospitals for reducing health care-associated SAB and VRE infections.” – by Caitlyn Stulpin
Disclosures: All authors report receiving grants from the National Health and Medical Research Council. Please see the study for all other authors’ relevant financial disclosures.