Optimizing the Management of Staphylococcus Aureus Bacteremia (OPTIMUS-SAB)

University of Alberta

Status: Enrolling

Conditions: Staph Aureus Bacteremia

Treatments: Other: OPTIMUS-SAB clinical care pathway

Study type: Interventional

Funder types: Other

Identifiers

NCT06338176

Pro00128904

Details and patient eligibility

About

Staphylococcus aureus bacteremia (SAB) is associated with high morbidity and mortality rates with an incidence disproportionately higher in vulnerable populations. Management according to evidence-based care parameters, in particular Infectious Diseases (ID) consultation, is associated with improved mortality. SAB management is suboptimal in Alberta compared to other jurisdictions. An Alberta-based pilot study confirmed that timely recommendations to optimize SAB care, including ID consultation, was associated with improved adherence to all evidence-based quality-of-care indicators.

Leveraging this pilot work, the investigators aim to implement OPTIMUS-SAB, an enhanced model of the pilot, to optimize and standardize SAB management across Alberta. The implementation study will be a zone-based acute care site stepped wedge design. OPTIMUS-SAB will consist of a centralized SAB care team whom will receive automated notification of all blood cultures positive for S. aureus allowing them to review the patient's medical chart and make preliminary management recommendations according to an evidence-based care bundle.

The investigators will evaluate adherence to evidence-based SAB quality-of-care indicators before and after OPTIMUS-SAB implementation and expect this to improve with a resultant reduction in duration of bacteremia, length of stay, readmission rates, and mortality. In turn, this will translate into cost savings for the health care system.

Enrollment: 1,800 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age greater than 18 years at the time of hospital admission
• Confirmed S. aureus bacteremia by blood culture performed at a laboratory in Alberta, Canada
• Admitted to a designated acute care site in Alberta, Canada

Exclusion criteria

• The treating team believes death is imminent or inevitable .
• GCD are C-level within 48 hours of admission.
• The patient is transferred in from an out-of-province acute care center with a pre-existing SAB diagnosis.

Trial design

Primary purpose: Health Services Research

Allocation: Non-Randomized

Interventional model: Sequential Assignment

Masking: None (Open label)

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1,800 participants in 2 patient groups

OPTIMUS-SAB care pathway

Experimental group

Description:

Province-wide real time automated notifications of new SAB cases will be established and delivered to a centralized SAB care team electronically through Connect Care. The centralized SAB care team consists of a SAB clinical coordinator, ID specialists and other ad hoc representation depending on patient needs. Following patient chart review, the centralized SAB care team contacts the most responsible physician (MRP) to provide preliminary recommendations to optimize care, both verbally and in written format, facilitated by Connect Care (Alberta Health Services electronic medical record).

Treatment:

Other: OPTIMUS-SAB clinical care pathway

Standard of care

No Intervention group