by John Stehle, Ph.D., CIC, CCHM | Director of Performance and Value and Chief Infection Prevention Consultant at Infinite Leap
Contact tracing is a key strategy required to prevent and control infectious disease outbreaks. It involves identifying and interviewing all contacts (i.e. staff, visitors, other patients) that may have come in contact with an infected person. Conventional contact tracing is very time consuming and tends to risk missing a significant number of potential contacts.
Conventional Contact Tracing
As shown in the infographic, after identifying a source patient, conventional contact tracing normally involves an infection preventionist or nurse reviewing the electronic medical record (EMR) to identify which staff may have had contact with the infected patient. This is followed by a nurse manager and other department managers reviewing schedules to identify potential staff. Finally, numerous interviews are conducted with the staff to determine whether contact occurred and to what extent. This time-consuming (i.e. days) process still ultimately misses potentially exposed people due to incomplete or missing documentation and recall bias.
Automated Contact Tracing
With automated contact tracing, such as that provided by WorkflowRT, staff and patients wear badges which monitor the individuals that have contact with the infected patient, along with the duration. Then, when an exposure occurs, a report is run that quickly provides a list of people who had contact with the infected patient, along with the location and duration of the contact. This enables the first step to be performed in a matter of minutes (vs hours or even days) and is more thorough since it does not suffer from incomplete documentation or recall bias.
As shown in the sample contact tracing report, the infection preventionist or nurse performing the contact tracing process is able to focus on staff or patients with the highest risk profiles due to length of contact and/or location of contact (i.e. small rooms).
It is important to note that automated contact tracing does not replace the need to perform interviews to confirm an exposure, or the necessity of next steps which may include monitoring, isolation, and/or prophylactic treatment. However, the first step can be completed in minutes and provide a complete list that should not require ongoing review and updating, which enables staff to work on other patient care activities.