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Clostridium difficile Infection Reduction Collaborative


Hand SanitationHealthcare-associated infections (HAI) are estimated to occur in 1.7 million patients in the US, leading to 99,000 deaths and resulting in additional cost of $28 to 33 billion. Clostridium difficile infection (CDI) is quickly becoming one of the most common HAIs.

Since 2003,CDI incidence and severity have increased, and mortality up to 17% has been reported in the U.S. and Canada. This increase in incidence and severity has been attributed to the emergence of a new strain of the disease and in the U.S., it is estimated that CDI causes 165,000 cases annually, 1.3 billion in excess cost and 9,000 deaths. CDI are a significant burden on hospitals due to increased length of stay and cost and up to 20% of CDI cases are associated with recurrences leading to hospitalization and increased cost of outpatient treatment. Therefore, CDI represents a significant economic burden and although excess attributable cost varies, studies indicate it may add about 7 days to the length of stay and $4,000 to the cost per case. Locally hospitals report that this disease is associated with sepsis, readmission and even death. The purpose of the Collaborative is to reduce the incidence of C. difficile disease in four Rochester hospitals.

Goals and Objectives

  • The main objective of this proposal is to reduce the burden of CDI in hospitalized patients by 30%
  • Another objective is to reduce the burden of CDI in key community skilled nursing facilities by 30%
  • The other objective is to reduce the burden of CDI in our community by 30%


The Rochester Infection Prevention Group consists of hospital epidemiologists and experienced Infection Preventionists (IPs). The group has worked together for several years on different infectious disease projects such as the CLABSI quality improvement project and worked together during the H1N1 pandemic influenza on standardizing policies across hospital systems.

We will initiate a quality improvement project to prevent CDI in hospitalized patients at 4 hospitals in Rochester: Strong Memorial Hospital, Highland Hospital, Rochester General Hospital and Unity Hospital. The focus will be on prevention of transmission by emphasizing hand hygiene and adequate cleaning of the environment through involvement of staff from multiple disciplines, education, observations, standardization of policies, and behavioral change theory implementation. The goal is to eventually share our experience with area skilled nursing facilities.

Proposed methods to achieve the above objectives:

  • Understanding the scope of CDI in the greater Rochester area by establishing an NHSN communication network to gather data on the incidence of CDI at the 4 hospitals and the community
  • Assessing existing policies and practices relating to CDI prevention at different hospitals in the greater Rochester area
  • Standardizing best practices for CDI Prevention across greater Rochester area
  • Monitoring adherence to standardized policies
  • Increasing education and awareness of CDI and the best practices for CDI prevention and control

An educational workshop to kick off this quality improvement project was held in October 2011.  Workshop attendees may access the content presented at the workshop by clicking on the password protected presentations listed below.

For more detailed information, please visit