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Manufacturing process helps Scottish hospital halve MRSA rates

BMJ 2001; 322 doi: https://doi.org/10.1136/bmj.322.7293.1014/d (Published 28 April 2001) Cite this as: BMJ 2001;322:1014
  1. Bryan Christie
  1. Edinburgh

    A system used to monitor variation in manufacturing processes in industry is proving successful in helping one of Scotland's largest hospitals control methicillin resistant Staphylococcus aureus (MRSA) infection at a time when rates are rising throughout the United Kingdom.

    New cases of MRSA infection at Glasgow Royal Infirmary have fallen to about half the levels experienced before the system was introduced in November 1999, down from 40–50 per month to 20–30 per month.

    A report by Glasgow's director of public health on the success of the pilot project is to be sent to the Scottish health department in the hope that other hospitals can benefit from the Glasgow experience. The system, known as statistical process control, is used more commonly in industry to identify increases in defect rates in manufacturing processes and other types of unnatural variation.

    Infection control staff use the system to feed back data about cases of MRSA infection to ward staff so that charts can be kept and progress logged at a glance. By identifying and tracking any infection at an early stage, it allows rapid control measures to be taken, such as additional cleaning. Staff at the hospital have described the system as the most meaningful form of MRSA feedback they have ever received.

    Greater Glasgow Health Board's director of public health, Dr Harry Burns, said it was really just another form of clinical audit: “This proves that if you audit processes and act on the results you can have an effect. Whenever there are any isolates of MRSA the ward gets told quickly and they are on top of it very quickly.”

    The success being achieved in Glasgow contrasts with the widespread failure to control MRSA infection throughout the NHS. Recorded cases of infection in Scottish hospitals have increased from 650 in 1995 to about 12 000 last year.

    MRSA poses a major hazard in hospitals and contributes to the wider problem of hospital acquired infection, which produces at least 100 000 cases in England every year and results in about 5000 deaths.

    The publication and dissemination of guidelines on how to deal with MRSA infection together with the efforts of infection control teams have failed to reverse the rising trend. Dr Burns said that the results being produced in Glasgow are exciting and that this inexpensive system, which is easy to implement, may offer an alternative approach.

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