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Center For Disease Dynamics, Economics & Policy

Optimizing hospitals to fight against MDROs

The question. The emerging threat of multidrug-resistant organism MDROs has posed an issue for many healthcare facilities and has caused an additional burden to hospitals under stress. As MDROs, like methicillin-resistant Staphylococcus aureus (MRSA), carbapenem-resistant Enterobacteriaceae (CRE), and vancomycin-resistant Enterococci (VRE), are becoming more common in hospitals, the design of hospitals must consider the impacts of these infections.

A collaborative research effort led by Dr. Marietta Squire at Johns Hopkins with researchers at CDDEP, Outreach Engineering in South Africa, and the Moss Clinic in the United States looked at how hospitals can optimize their design to reduce the spread of MDROs. The study utilized computational models and data from US Army hospitals to optimize the installation of handwashing stations, humidity control, and negative-pressure rooms to provide cost-effective infection control.

What we found. The study concluded that enormous costs associated with infections are avoided with optimal investment in various infection control interventions for large, community, and small acute care hospitals. In large hospitals, up to 69% of MDRO infections could be mitigated with direct cost-savings of $1.5 million.

Why it matters. The application of engineering optimization provides decision makers a framework for designing hospitals and their built environment to prevent MDROs within a budgetary constraint. For developing countries that suffer from resource scarcity, a tool that provides design recommendations can empower hospital designers to continue their fight against AMR.

The study titled “Optimal Design of Paired Built Environment Interventions for Control of MDROs in Acute Care and Community Hospitals” was published in Health Environments Research & Design Journal and is available here.   

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