msipc fundamentals: interaction between ips and local and state health departments joyce lai, mph–...
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MSIPC Fundamentals: Interaction between IPs and Local and State Health Departments
Joyce Lai, MPH– Michigan Department of Community HealthNoreen Mollon, MS– Michigan Department of Community Health
October 29, 2014
www.michigan.gov/hai
Outline
MDCH Organization Communicable Disease Surveillance
Reportable Diseases Michigan Surveillance Data Systems
MDSS MSSS Sentinel Surveillance for ILI
SHARP Outbreak Response Surveillance and Reporting Prevention Initiatives
Other MDCH Entities that frequently interact with IPs
MDCH Mission Statement
MDCH will protect, preserve, and promote the health and safety of the people of Michigan with particular attention to providing for the needs of vulnerable and under-served populations
MDCH Organization
Operations Administration
Medical Services Administration
Behavioral Health &Developmental
Disabilities Administration
Office of Inspector General
Offices of Services To the Aging
Chief OperatingOfficer
DIRECTOR
Public HealthAdministration
MDCH Organization
Public Health Administration
Bureau of Local Health& Administrative Services
Bureau of Family, MaternalAnd Child Health
Bureau of Disease Control, Prevention, and Epidemiology
Bureau of Laboratories
Division of Health Wellness And Disease Control
Office of Public Health Preparedness
MDCH Organization
Bureau of Disease Control, Prevention, and Epidemiology
Division of Genomics, Perinatal Health, and Chronic Disease
Division of Immunization
Division of Environmental Health
Division of Communicable Disease
Surveillance Section
Communicable Disease Surveillance
Communicable disease reporting is required by Michigan law: Michigan Public Health Act No. 368 Communicable
Disease Rules: R 325.171-3, 333.5111 Rule revision allows the State the right to periodically
update the list of reportable diseases This reporting is expressly allowed under HIPAA
Hepatitis C Virus Neisseria meningitidis Histoplasma capsulatum Bordetella pertussis
Why Communicable Disease Surveillance is Important To identify outbreaks To assure treatment, preventive treatment and/or
education To evaluate prevention and control programs To help target prevention resources To facilitate epidemiologic research To assist national and global surveillance efforts
Salmonella sp.Influenza VirusChlamydia trachomatis Mycobacterium tuberculosis
Public Health Depends on Collaboration
HealthcareProviders
ClinicalLaboratories
Local HealthDepartment
State HealthDepartment
Centers for DiseaseControl and Prevention
Isolates and specimenssent to State Lab for
additional testing
Communicable Disease Reporting Entities Physicians* Laboratories* Hospital ICP Private citizens School systems* Pharmacists Veterinarians Medical Examiners
Hospitals* Child care facilities Long-term care
facilities* Pre-hospital
emergency services Police Fire EMS
*Required to report
Communicable Disease “Brick Book”
The current 2014 version (electric crimson), provides a good summary of the communicable disease rules, requirements, and responsibilities
Michigan Reportable Diseases
~90 disease/conditions are reportable in Michigan
Also reportable are ‘unusual occurrences’, outbreaks and epidemics of any disease or condition (including healthcare-associated infections)
Specific reporting rules and definitions can be found at www.michigan.gov/cdinfo
Case Rules and Definitions
Example of Streptococcus pneumoniae reporting algorithm
Case Rules and Definitions
Acute / Chronic Hepatitis C Reporting Flowchart
Timeliness and Completeness of Communicable Disease Reports
In general, all reportable diseases are required to be reported within 24 hours of confirmation
Report contents Demographic info – name, date of birth, sex, race Contact info – address, phone number Disease details – onset date, lab results
Surveillance is only as good as the data received The timeliness and effectiveness of public health
responses are dependent on prompt and accurate surveillance reporting
Authority of State and Local HDs
Michigan is a “home rule” state, meaning local HDs have autonomy within their jurisdiction
The MDCH operates independently from the local HDs
The primary role of the MDCH in communicable disease control is to provide: expert consultation reference level diagnostics laboratory services childhood vaccines support local HDs upon their request Maintenance and administration of the MDSS
All communicable disease reports should be reported to your local HDs
Map of Michigan Local HDs
Public Health Investigative Authority
State and local HD personnel are authorized to investigate reported diseases, including: Contacting health providers Conducting additional case-finding Conducting epidemiological studies Conducting specimen collection Gathering information on medical history, lab results,
diagnostic procedures, treatment, and health outcomes
The MDCH works collaboratively with the local HDs and participates in investigations when requested
Confidentiality, HIPAA, and PHI
Disclosure of protected health information (PHI) to health authorities without individual consent or authorization is permitted when disclosure is required by law or is authorized by law for a public health purpose (www.hhs.gov/ocr/hipaa/)
All information provided to public health authorities is kept confidential
Helpful Links
www.michigan.gov/mdch Click on ‘Providers’ and then ‘Chronic and
Communicable Diseases’ www.michigan.gov/hivstd - HIV/STD/Viral Hepatitis
www.michigan.gov/cdinfo - Communicable Disease resources, forms, links, reports, and publications
www.michigan.gov/mdss - Michigan Disease Surveillance System (MDSS)
www.michigan.gov/hai- Healthcare-Associated Infection Surveillance & Prevention
Michigan Surveillance Systems
Michigan Disease Surveillance System (MDSS)
Michigan (Emergency Department) Syndromic Surveillance System (MSSS)
Sentinel Surveillance for Influenza-Like Illness
Disease Detection/Reporting Timeline
ExposureSymptom
OnsetSeeking of
Medical Care
Diagnosis
Reported to Local HD
Reported to State HD
ED SyndromicSurveillance
Michigan DiseaseSurveillance System
Time
Michigan Disease Surveillance System
Web-based communicable disease surveillance system Disease can be reported 24/7 from your computer Used to facilitate coordination between local, State,
and federal public health agencies Streamlines disease reporting; more efficient and
closer to real-time Allows for more timely public health interventions Reduces delays in public health follow-up by grouping
disease based on county of patient residence
Data in the MDSS can be accessed and edited by multiple parties which facilitates the sharing of information without requiring multiple phone calls
Allows for instantaneous retrieval of summary reports MDCH Weekly Surveillance Report (
www.michigan.gov/cdinfo) Data sent to CDC National Notifiable Disease Surveillance
System (NNDSS – www.cdc.gov/nndss) for Morbidity and Mortality Weekly Reports (MMWR – www.cdc.gov/mmwr)
Michigan Disease Surveillance System
MDSS Reporting Pathways
Community Physicians InfectionPreventionists
Hospital Labs
Local Health Department
• Case Follow-up• Local Surveillance• Electronic Reports
MDCH
• Statewide Surveillance• Weekly Surveillance Reports (WSR)
CDC• National Notifiable Disease Surveillance System (NNDSS)• Morbidity and Mortality Weekly Report (MMWR)
MDSS
Adding/Editing Cases in MDSS
Searching Records in MDSS
Pulling MDSS Data
Pulling MDSS Data
MDSS Statistics
Year ReferralsIndividual Case Reports Transactions
UniqueUser
Log Ins
2007 83,876 77,686 400,000 ----
2008 136,057 104,616 429,848 783
2009 160,326 119,843 618,731 893
2010 158,225 113,765 697,258 906
2011 213,639 159,185 803,092 982
2012 211,150 146,069 1,018,304 1,126
2013 185,362 126,812 1,059,023 1,155
MDSS Electronic ReportingLABORATORY 2006 2007 2008 2009 2010 2011 2012 2013
MDCH REGIONAL LAB - LANSING 16,407 7,039 13,589 20,723 16,245 18,567 22,305 20,905
DETROIT MEDICAL CENTER LAB 1,167 8,652 8,758 8,882 9,816 10,147 8,981 7523
MDCH REGIONAL LAB - DETROIT 1,206 1,323 2,040 1,596 1,662 1,714 369 12
ARUP LABORATORIES 2,100 3,656 2,678 3,314 3,498 3,209 5,680 5621
GARCIA LABORATORIES -- -- 483 -- -- 8
HURLEY HOSPITAL LAB (3/09) -- -- -- 3,024 3,792 5,031 4,448 2874
MAYO CLINICAL LABS (8/09) 1,548 6,668 3,985 4,317 3375
LABCORP (9/09) 1,226 3,375 4,225 4,957 5149
MDCH REGIONAL LAB – OAKLAND (9/09) 863
MDCH REGIONAL LAB - OAKLAND CO LAB - PONTIAC 2,823 2,552 2,188 2106
MDCH REGIONAL LAB - OAKLAND CO LAB - SOUTHFIELD 425 676 552 758
MDCH REGIONAL LAB - KALAMAZOO 340 1,359 127 123
MDCH REGIONAL LAB - UPPER PENINSULA 57 0 0 0
MDCH REGIONAL LAB - KENT COUNTY 412 1,757 268 204
MDCH REGIONAL LAB - SAGINAW COUNTY 308 1,632 3,189 2288
SPARROW LABS (2/11) 1,735 2,281 2161
SPARROW LABS – ST LAWRENCE LAB (2/11) 2,104 2,712 2965
QUEST DIAGNOSTIC – AUBURN HILLS (8/11) 4,969 12,510 16420
McLAREN OAKLAND HOSPITAL 16
McLAREN CENTRAL MI HOSPITAL 5
McLAREN MACOMB HOSPITAL 27
McLAREN FLINT HOSPITAL 27
McLAREN BAY HOSPITAL 26
McLAREN GREATER LANSING HOSPITAL 7
Total 20,880 20,670 27,548 41,176 49,421 63,662 74,884 72600
More Info on the MDSS
Contact: Your Local Health Department Communicable
Disease Program Your Regional Epidemiologist Edward Hartwick, MS, MDSS Coordinator
http://www.michigan.gov/mdss
(517) 335-8165
Michigan (Emergency Department) Syndromic Surveillance (MSSS)
A surveillance system that detects and tracks the chief complaints of ED patients throughout the state
Chief complaints are classified into syndromic categories that could indicate a possible public health emergency
Web-based application displays the data in real-time
Alerts are automatically sent when rates of a given syndrome are detected to be higher than the predicted norm
MSSS
# of facilities: 95
# of users: 173
# of referrals per day, Statewide: 12,343
# of referrals per day, per facility: 130
MSSS Data
Each message sent to the MSSS consists of: Demographics: date of birth, sex Residence: home zip code Visit Info: date, time, class (e.g. urgent care, ER) Chief Complaint
MSSS Chief Complaints
Chief complaints are classified into the following syndromes:
Hemorrhagic Botulinic Neurological Other Default
Gastrointestinal Constitutional Respiratory Rash
MSSS Classification Examples
Chief Complaint Syndrome“slurred speech” Botulinic
“general weakness” Constitutional“stomach pain” Gastrointestinal
“difficulty breathing” Respiratory“nose bleed” Hemorrhagic
“headache” Neurological “hives and itching” Rash“right foot injury” Other
“med refill” Default
MSSS Alerts
A detection algorithm monitors the data hourly
An e-mail alert is sent to State and regional epidemiologists if an aberration is detected If the actual value of a syndrome exceeds the predicted
value for a given syndrome in a geographic area
Users can view the data in charts, graphs, or maps
Use of MSS Data
Early detection of outbreaks Enhanced surveillance during high-profile events:
World Series Super Bowl MLB All-Star Game Final Four Detroit Auto Show
Seasonal influenza monitoring Situational awareness
Sentinel Provider Surveillance for Influenza-Like Illness (ILI) Michigan component of the CDC U.S. Outpatient
Influenza-like Illness Surveillance Network Influenza sentinel reports provide data on over
12,000 outpatient office visits per week and are an important part of influenza surveillance in Michigan
Contact Stefanie DeVita at 517-335-9104 or [email protected] for more information
Michigan Influenza Sentinel Hospital Network MDCH is working to establish a network of sentinel
hospitals that report influenza-associated hospitalizations
Hospitals that agree to participate would be asked to provide: Weekly report consisting of the number of influenza-
associated hospitalizations in each of five age categories Total number of admissions during that time frame Contact:
Sally Bidol ([email protected])
www.michigan.gov/hai
Surveillance for Healthcare-Associated and Resistant Pathogens (SHARP) Unit
Objectives of the SHARP Unit: Coordinate activities related to HAI surveillance and
prevention in Michigan Improve surveillance and detection of antimicrobial-
resistant pathogens and HAIs Identify and respond to disease outbreaks Use collected data to monitor trends Educate healthcare providers, state and
local public health partners, and the public on HAIs
SHARP Activities
Outbreak Response Surveillance and Reporting MDRO Prevention Initiatives Consulting/Education
Staphylococcus aureus
Clostridium difficileKlebsiella pneumoniae
www.michigan.gov/hai
The MDCH SHARP staff are available to offer our services and expertise in healthcare-associated outbreak investigations
MDCH can help facilities coordinate molecular testing with the MDCH Bureau of Laboratories to identify genetic-relatedness between patient isolates (at no cost)
Outbreak Response
Acinetobacter baumannii
www.michigan.gov/hai
Surveillance and Reporting
Vancomycin-Intermediate Staphylococcus aureus (VISA) and Vancomycin-Resistant Staphylococcus aureus (VRSA) are required to be reported according to the communicable disease rules
Unusual occurrences and outbreaks of HAIs are also mandated by law to be reported
However, individual HAIs (like a CLABSI), are not required to be reported to state or local health departments
www.michigan.gov/hai
33 states have laws requiring HAIs to be reported to state health departments, the majority of which publically release hospital HAI rates (http://www.jstor.org/stable/10.1086/663204)
Surveillance and Reportingwww.michigan.gov/hai
In Michigan, hospitals can voluntarily report HAIs to MDCH SHARP via the National Healthcare Safety Network (NHSN)
NHSN is a web-based surveillance program designed by CDC: Uses standardized HAI surveillance definitions Users can enter and analyze HAI data
The data sent to SHARP from Michigan hospitals are de-identified and the numbers aggregated for the purposes of producing state-wide HAI surveillance reports
Surveillance and Reportingwww.michigan.gov/hai
HAIs tracked by MDCH SHARP surveillance:• Central Line-Associated Blood Stream Infection (CLABSI)• Surgical Site Infection (SSI)• Catheter-Associated Urinary Tract Infection (CAUTI)• Ventilator-Associated Pneumonia (VAP)• Clostridium difficile LabID surveillance• MRSA LabID surveillance• Antimicrobial resistance in select pathogens
Surveillance and Reportingwww.michigan.gov/hai
Staphylococcus aureus
Subclavian central venous line
Mechanical ventilator
Surgical incision showing signs of infection
Clostridium difficile
Foley catheter insertion kit
SSI
CLABSI
VAP
CAUTI
CDI LabID
MRSA LabID
HAI Surveillance
SHARP Surveillance Currently there are 97 Michigan hospitals sharing HAI data with SHARP, with all 97 hospitals releasing their data to the
Michigan Health and Hospital Association MHA Keystone Center, and 14 hospitals releasing their NICU data to the Vermont Oxford Network (updated 9-17-14).
www.michigan.gov/hai
2009 2010 Q1
2010 Q2
2010 Q3
2010 Q4
2011 Q1
2011 Q2
2011 Q3
2011 Q4
2012 Q1
2012 Q2
2012 Q3
2012 Q4
2013 Q1
2013 Q2
2013 Q3
2013 Q4
2014 Q1
2014 Q2
2014 Q3
0
20
40
60
80
100
120
Number of Acute Care Hospitals that have Signed a Data Use Agreement with MDCH SHARP
Master Agreement MHA Data Release VON Data Release
Num
ber
of H
ospi
tals
SHARP Reports
SHARP releases state-wide HAI reports quarterly, semiannually, and annually which are posted at www.michigan.gov/hai All hospital data are de-identified and aggregated Individual hospital data is not made public
SHARP also compiles hospital specific HAI reports which are only shared with those individual hospitals
www.michigan.gov/hai
SHARP HAI Datawww.michigan.gov/hai
2011 Q1 2011 Q2 2011 Q3 2011 Q4 2012 Q1 2012 Q2 2012 Q3 2012 Q4 2013 Q1 2013 Q2 2013 Q3 2013 Q40
1
2
3
4
5
6
Michigan MRSA LabID Rates
MI MRSA LabID MI MRSA Bld LabID
MRS
A La
bID
Rate
per
1,0
00 P
atien
t Day
s
SHARP HAI Datawww.michigan.gov/hai
2013 Q1 2013 Q2 2013 Q3 2013 Q40%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Inpatient MRSA LabID Onset Distribution
CO Bacteremia Community-Onset (CO) HO Bacteremia Healthcare Facility-Onset (HO)
SHARP HAI Datawww.michigan.gov/hai
2011 Q1 2011 Q2 2011 Q3 2011 Q4 2012 Q1 2012 Q2 2012 Q3 2012 Q4 2013 Q1 2013 Q2 2013 Q3 2013 Q40
2
4
6
8
10
12
14
16
18
20
22
24
Michigan C. diff LabID Rates
C. d
iff La
bID
Rate
per
10,
000
Patie
nt D
ays
SHARP HAI Datawww.michigan.gov/hai
2013 Q1 2013 Q2 2013 Q3 2013 Q40%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Inpatient CDI LabID Onset Distribution
Community-Onset Community-Onset, Healthcare Facility-Associated Healthcare Facility-Onset
SHARP HAI Datawww.michigan.gov/hai Standardized Infection Ratios (SIR)
Type of Infection Number of Hospitals
Procedures Done Device Days or Patient Days
Observed1 Predicted2 MI SIR3 MI p-value4 MI 95% CI5
CAUTI6 87 N/A 100,676 DD 274 219.2497 1.250 0.0004 1.108, 1.404CLABSI7 84 N/A 91,900 DD 86 192.9266 0.446 <0.0001 0.359, 0.561CLABSI ICU8 84 N/A 82,973 DD 77 170.4866 0.452 <0.0001 0.359, 0.561CLABSI NICU9 17 N/A 8,927 9 22.4400 0.401 0.0016 0.196, 0.736SSI10 81 13,514 N/A 239 309.5430 0.772↓ <0.0001 0.679, 0.875SSI COLO11 80 2400 N/A 117 143.9260 0.813↓ 0.0237 0.675, 0.971SSI HYST12 74 2162 N/A 48 40.7430 1.178 0.2595 0.878, 1.549MRSA Bac LabID13 85 N/A 1,189,685 PD 79 89.4367 0.883 0.2685 0.704, 1.095
C.diff LabID14 85 N/A 1,109,626 PD 834 926.2102 0.900 0.0022 0.841, 0.963
Michigan Data US Data
1Observed: Number of infections (CAUTI, CLABSIs or SSIs) reported during the time frame.2Predicted: The number of CAUTIs or CLABSIs predicted based on the type of hospital unit(s) under surveillance, or the number of SSIs predicted based upon 2009 national SSI rates by procedure type. 3SIR: Standardized Infection Ratio: Ratio of observed events compared to the number of predicted events, accounting for unit type or procedure. An SIR of 1 can be interpreted as having the same number of events that were predicted. An SIR that is between 0 and 1 represents fewer events than predicted, while an SIR of greater than 1 represents more events than expected. 4P-value: An SIR p-value of <0.05 is considered significantly different than expected. It can be either significantly worse (if the SIR is greater than 1 and the p-value is <0.05) or significantly better (if the SIR is less than 1 and the p-value is <0.05). 595% CI: 95% confidence interval around the SIR estimate. A 95% CI indicates that 95% of the time, the actual SIR will fall within this interval.6CAUTI: Catheter-Associated Urinary Tract Infection. CAUTIs are defined using symptomatic urinary tract infection (SUTI) criteria or Asymptomatic Bacteremic UTI (ABUTI) criteria. UTIs must be catheter-associated (i.e. patient had an indwelling urinary catheter at the time of or within 48 hours before onset of the event).7CLABSI: Central Line-Associated Blood Stream Infection. CLABSIs are laboratory-confirmed bloodstream infections (LCBI) that are not secondary to a community-acquired infection, or an HAI meeting CDC/NHSN criteria at another body site. BSIs must be central line associated (i.e., a central line or umbilical catheter was in place at the time of, or within 48 hours before, onset of the event).8CLABSI ICU: CLABSIs from ICU locations only9CLABSI NICU: CLABSIs from NICU locations only 10SSI: Surgical Site Infection. Includes any superficial incisional, deep incisional, or organ/space SSI. 11SSI COLO: Inpatient Colon surgeries 12SSI HYST: Inpatient Abdominal Hysterectomies 13MRSA Bacteremia LabID: Inpatient facility-wide MRSA bacteremia Laboratory-identified Event14Clostridium difficile LabID: Inpatient facility-wide Clostridium difficile Laboratory-identified Event↓ or Indicates statistically significantly lower or higher than previous quarter (respectively). Green Text or Red Text indicates significantly fewer or greater infections than expected .
SHARP HAI Datawww.michigan.gov/hai
2013 Q1* 2013 Q2* 2013 Q3* 2013 Q4*0
0.2
0.4
0.6
0.8
1
1.2
1.4
1.6
CAUTI Standardized Infection Ratios
Time Period
CAU
TI S
IR
*=Significantly different from 1**=Significantly different from previous month
SHARP HAI Datawww.michigan.gov/hai
2013 Q1* 2013 Q2* 2013 Q3* 2013 Q4*-1.66533453693773E-16
0.2
0.4
0.6
0.8
1
1.2
CLABSI Standardized Infection Ratios
Time Period
CLAB
SI S
IR
*=Significantly different from 1**=Significantly different from previous month
SHARP HAI Datawww.michigan.gov/hai
2013 Q1* 2013 Q2** 2013 Q3 2013 Q4* **0
0.2
0.4
0.6
0.8
1
1.2
1.4
SSI Standardized Infection Ratios
Time Period
SSI S
IR
*=Significantly different from 1**=Significantly different from previous month
SHARP HAI Datawww.michigan.gov/hai
2013 Q1* 2013 Q2 2013 Q3 2013 Q4* **0
0.2
0.4
0.6
0.8
1
1.2
1.4
SSI COLO Standardized Infection Ratios
Time Period
SSI C
OLO
SIR
*=Significantly different from 1**=Significantly different from previous month
SHARP HAI Datawww.michigan.gov/hai
2013 Q1 2013 Q2 2013 Q3 2013 Q40
0.2
0.4
0.6
0.8
1
1.2
1.4
1.6
1.8
SSI HYST Standardized Infection Ratios
Time Period
SSI H
YST
SIR
*=Significantly different from 1**=Significantly different from previous month
SHARP HAI Datawww.michigan.gov/hai
2013 Q1* 2013 Q2 2013 Q3 2013 Q40
0.2
0.4
0.6
0.8
1
1.2
1.4
1.6
MRSA Bac LabID SIRs
Time Period
MRS
A B
ac L
abID
SIR
SHARP HAI Datawww.michigan.gov/hai
2013 Q1* 2013 Q2*,** 2013 Q3* 2013 Q4*0
0.2
0.4
0.6
0.8
1
1.2
CDI LabID SIR
Time Period
CDI L
abID
SIR
MDRO Prevention Initiatives SHARP also has started two prevention initiatives aimed to
reduce the incidence and prevalence of MDROs in healthcare facilities in Michigan:
Clostridium difficile (CDI) surveillance and prevention initiative
Carbapenem-Resistant Enterobacteriaceae (CRE) surveillance and prevention initiative
Enterobacter cloacaeCitrobacter freundii Klebsiella pneumoniaeEscherichia coli
Staphylococcus aureus
SHARP recruited facilities into the two initiatives
Both will measure the baseline prevalence and incidence of their respective organisms
Then there will be a period of measurement during which facilities are encouraged to begin implementing infection prevention interventions to reduce the transmission of these organisms
MDRO Prevention Initiatives
Planning Stage Baseline Stage Intervention Stage
www.michigan.gov/hai
Education and Consulting
Another primary focus of the SHARP unit is increasing awareness of HAIs, answering FAQs, and disseminating best-practice and evidence-based recommendations and guidelines
Examples of entities/persons that ask for our guidance: IPs
Local HDs Healthcare workers Schools
Gyms Correctional Facilities Students Public
www.michigan.gov/hai
Special Collaboration
SHARP collaborates with the MDCH Viral Hepatitis Unit: Investigating potentially healthcare-related viral
hepatitis infections (e.g. David Kwiatkowski) Works jointly on injection safety-related educational
campaigns (e.g. One and Only campaign) Contact information
(517)335-8165 www.michigan.gov/hivstd (click on the hepatitis link)
www.michigan.gov/hai
SHARP Unit Contacts(517) 335-8165www.michigan.gov/hai
o Jennie Finks, DVM, MVPH – HAI Coordinator and Unit [email protected]
o Jennifer Beggs, MPH – Infectious Disease and Preparedness [email protected]
o Allison Murad, MPH – National Healthcare Safety Network (NHSN) Epidemiologist [email protected]
o Noreen Mollon, MS – Infection Prevention [email protected]
o Gail Denkins, RN – CDI Prevention Initiative [email protected]
o Brenda Brennan, MSPH – CRE Prevention Initiative [email protected]
www.michigan.gov/hai
Other MDCH Entities that Interact with IPs
Bureau of Labs (BOL) Office of Public Health Preparedness (OPHP) Licensing and Regulatory Affairs (LARA)
Michigan Occupational Safety and Health Administration (MIOSHA)
Healthcare Facility Engineering Michigan Care Improvement Registry (MCIR)
MDCH Bureau of Labs (BOL)
Main Phone: (517) 335-8063
Tours available quarterly, to schedule call (517) 335-9654
MDCH BOL Testing www.michigan.gov/mdchlab
List of Tests performedBy MDCH BOL
Forms required toRequest testing
Regional Reference Labs
Report Suspected Bioterrorism: Lansing: (517) 335-8063 Kalamazoo: (269) 373-5360 Grand Rapids: (616) 632-7210 Saginaw: (989) 758-3825 Oakland County: (248) 858-1310
Office of Public Health Preparedness (OPHP)
Purpose of OPHP is to establish strategic leadership, direction, assessment, and coordination of activities to ensure statewide readiness and interagency collaboration to respond to public health emergencies.
Michigan Emergency Management System
President of US Governor
Michigan State PoliceState Director of Emergency Management
DHS / FEMA Emergency ManagementDivision (EMD) MDCH
EMD District Coordinators
Local Health Departments
Local Emergency Management
Health Preparedness Regions
All emergencies and disasters are local
www.fema.gov/nims
Emergency Preparedness Collaboration
Utilities
Transportation
EmergencyManagement
Fire &Rescue
PublicHealth
HospitalsEMS
LawEnforcement
Public Works
Industry /Private Sector
www.fema.gov/nims
Emergency Preparedness Communication
Statewide communication capabilities:
Michigan Statewide Comprehensive Interoperable Communication Plan
Public Health Safety Communication System (800Mhz radios)
Health Alert Network (HAN)
Emergency Preparedness Regions
8 Michigan Emergency Preparedness Regions: Modeled after State Police
Regions Encompass 45 Local HD
Emergency Preparedness Centers
Each Region contains: Medical Director Hospital Bioterrorism
Coordinator Epidemiologist
Strategic National Stockpile
Able to distribute large quantities of pharmaceuticals and medical supplies during an emergency
Local HDs and hospitals are prepared to receive MISNS assets
MISNS is capable of delivering assets via ground or air transport
OPHP Contacts
Linda Scott – Hospital Preparedness Coordinator (517) 335-8150 [email protected]
Mary Macqueen – Public Health Preparedness Coordinator (517) 335-8150 [email protected]
MIOSHA – Michigan Occupational Safety and Health Administration
MIOSHA operates under Licensing and Regulatory Affairs (LARA)
For healthcare inquiries contact MSIPC’s MIOSHA liaison Eric Zaban: (517) 882-1022
For general consultation and/or training contact: (517) 322-1809
www.michigan.gov/miosha
LARA- Health Facilities Engineering
Provide enforcement and interpretation of the minimum healthcare facility design standards to reduce the risk of transmission
Kasra Zarbinian (517) 241-3422
www.michigan.gov/hfes
Michigan Care Improvement Registry (MCIR) www.mcir.org
Web-based system created in 1998to collect children’s immunizationinformation
Expanded in 2006 to include adults (lifespan registry) Consolidates immunization information from
multiple data sources and provides immediate, real-time, patient immunization history
Assists with all-hazard preparedness by tracking vaccines and medications during a public health emergency
MCIR Activity
9 million records
Over 83 million shot records
29,000 registered users
5,500 active provider sites
The Benefits of MCIR
High healthcare provider participation (90%) Reports indicate ‘pockets of need’ Flexibility, allowing linkages with other public
health systems Types of information available in MCIR: Patient Immunization status at time of visit
Reminders/recall letters Coverage level reports High risk influenza Newborn screening Lead results Early hearing detection and intervention (EHDI)
Immunization Information
Annual Fall Conferences – www.michigan.gov/immunize
AIM Kits – www.aimtoolkit.org
Influenza information “FluBytes”– www.michigan.gov/flu
Quarterly Newsletters – send an e-mail with SUBSCRIBE in the subject line to [email protected]
Beatrice Salada, State MCIR Coordinator [email protected] www.mcir.org
Thanks!
Questions or comments?
Joyce Lai (734) 727-7204 [email protected]
Noreen Mollon (517) 335-6582 [email protected]