An hour in the life of an influenza case

St. Michael’s Hospital infection preventionist Shara Junaid is at her desk when the phone rings. It’s the hospital lab; a patient in the Emergency Department has tested positive for Influenza A.

In the past, Junaid’s next step would have been to create a case profile by opening the patient’s electronic medical record and cutting and pasting details into a new Excel spreadsheet.

Today, thanks to RL6:Infection software, provided by the Canadian company RL Solutions, the lab results have already popped up on her computer in an alert, and the patient’s details are already on her desktop when the lab calls.

Junaid is part of a dedicated group of infection control professionals who provide 24/7 coverage for infection prevention emergencies at St. Michael’s, as well as education, surveillance and policy development. While the patient’s care team is responsible for isolating and treating the patient, the Infection Prevention and Control Team helps track and prevent an infection’s spread.

Everyone involved must move quickly. First, Junaid needs to know the patient’s basic clinical details.

“This software can pull info right away from the patient’s electronic medical record, info that we would otherwise have to find manually,” said Junaid. “We can create new profile in just a few clicks, with much less room for error.”

The patient’s history shows that he was discharged from St. Michael’s Orthopedics Ward the previous day. This means that Junaid must quickly trace the patient’s contact history, to identify other patients in the ward who may have been exposed to the virus.

“We used to have to print out and manually review hospital censuses for every day the patient was in hospital and considered infectious,” said Junaid. “But now that our software is integrated with our Admission, Discharge and Transfer System, I can generate a list of previous roommates within minutes – who they were, how long they were in contact with the patient and their current location.”

About 15 minutes later, Junaid is ready to notify units about the patients who may have been exposed to the influenza virus. At minimum, they’ll be isolated and closely observed for the next few days.

“We’ve always had access to the lab system, the medical records system and the admission, discharge and transfer system,” said Junaid. “We had our own documentation as well, but the process of manually integrating and documenting all the data was time consuming. To be able to use a single program to access, pull from and generate reports from all these sources means we can investigate and act much faster.”

Each potentially exposed patient now has his or her own profile in RL6:Infection.This means that if a patient is discharged and then readmitted a few days later, the software will notify the Infection Prevention and Control Team with an alert. They can then follow up to find out if the new admission is related to the in-hospital influenza exposure – an early warning sign of a hospital outbreak.

These profiles not only help the team keep track of current cases and potential exposures, but also draw attention to patients who may need special precautions due to a positive test at another facility, or a recent stay in a facility that’s experiencing an outbreak.

“Transitioning to the new software has been smooth,” said Junaid. “We are continuing to learn how we can optimize the system for our needs, and it’s a simple, user-friendly interface. The developers also have an infection preventionist on their team who helped us with implementation – it saved us a lot of time because she understood our work.”