The transmission and infection risk associated with multidrug-resistant organism (MDRO)
carriers necessitates surveillance and tracking to provide proper contact precautions. As MDROs increase
in scope, automated electronic health record (EHR) systems may help with surveillance demands.
Methods: We created a system for MDROs and Clostridium difficile tracking that automated the following
3 main surveillance and tracking activities: monitoring of microbiology results and initiation of chart-
based flags, ordering of contact precautions on admission, and ensuring appropriate removal of
precautions.
Results: Automation saved 43 infection preventionist hours per 1,000 admissions, in addition to previ-
ously unquantified hours spent reviewing MDRO history for every admission. Automatic retiring of
certain MDRO flags ensured removal of contact precautions after a specified time. A point-prevalence
assessment for eligibility for discontinuation found that all precautions were appropriate, with none
eligible for removal. By integrating microbiology data, EHR tracking flags, and automated orders, this
system assured rapid and comprehensive placement of patients into contact precautions without
requiring oversight by infection prevention personnel.
Conclusion: We show that automated systems embedded within EHRs can ensure tracking and appli-
cation of appropriate contact precautions while simultaneously producing tremendous time savings for
infection prevention programs.