Glossary

Acute Teaching Hospital

Acute teaching hospitals include acute and paediatric hospitals that provide complex patient care, are affiliated with a medical or health sciences school, and have significant research activity and postgraduate training.

Clostridium difficile

Clostridium difficile is a spore-forming bacteria that is present in the environment and can colonize up to 3-5% of adults in the community without causing symptoms.

Clostridium difficile infection (CDI)

CDI is a disease that damages the bowel as a result of C.difficile bacteria growth.

CDI Outbreak

The outbreak definitions have been revised to incorporate the concept of notification thresholds, which are more sensitive than outbreak definitions. Once a threshold is reached, a discussion between the local medical officer of health (MOH) and the facility is required to initiate an investigation and determine if there is an outbreak.

Following consultation between the institution and the Medical Officer of Health (MOH), decisions on the declaration of an outbreak will be made based on the following two criteria :

• Significant* (as determined by the facility and health unit) increase in CDI numbers or rate compared to own baseline and/or that of comparator institutions
• Epidemiologic evidence of ongoing nosocomial transmission within the ward/unit or facility

*Significance may be determined by reviewing :

• Number of new nosocomial cases associated with the reporting ward/unit or facility;
• Historic level of CDI activity of the ward/unit or facility;
• Current trend in ward/unit CDI activity or facility rate;
• Location of current cases and possible epidemiologic links between cases;
• Current control measures (and evidence that they are being implemented).

Declaration of an outbreak can be made by either the institution or the MOH.

CDI Rates

The rate is calculated by dividing the number of new cases observed at the hospital site by the number of patient days per reporting period, multiplied by 1000. Rates are expressed as cases per 1,000 patient days and exclude patients less than one year of age. This rate calculation allows the level of hospital activity to be taken into account, which may fluctuate over time and is different across hospitals.

Complex Continuing Care Hospital

Complex continuing care hospitals have their own building, chief executive officer (CEO), and board. They report data to the Ontario Ministry of Health and Long-Term Care separately from other hospitals or facilities and usually do not have acute care patients.

Hospital Patient Days

Patient days are the number of days spent in a hospital for all patients. For example, if there are 100 patients in a hospital for 10 days, that totals 1000 patient days (100 x 10).

IPC

Infection Prevention and Control.

Large Community Hospital

Large community hospitals are hospitals that are not defined as small or teaching.

LHIN

Local Health Integration Networks (LHINs) are not-for-profit corporations that work with local health providers and community members to determine the health service priorities of their regions. LHINs do not provide services directly; instead they are responsible for integrating services in each of their specific geographic areas. LHINs work with local health providers and community members to develop integrated health service plans for their local area.

Mental Health Hospital

Mental health hospitals serve individuals with more complex treatment and behavioural management needs. Their patients typically require a longer length of stay.

Monthly Case Count

The number of patients with hospital-acquired CDI during a calendar month.

Nosocomial

Infections acquired in the hospital.

PHU

Public Health Unit.

Rehabilitation Hospital

Rehabilitation hospitals provide rehabilitation for clients with a primary health condition that is physical in nature (e.g. stroke, orthopedic conditions, brain dysfunction, spinal cord dysfunction or amputation) in publicly-funded, designated adult rehabilitation beds.

RICN

Regional Infection Control Networks (RICNs) are designed to coordinate infection prevention and control activities and promote standardization in healthcare facilities across Ontario. Development of the networks has brought together infection prevention and control and infectious diseases expertise from relevant fields across the health care continuum including acute care, public health, community care and long-term care homes. There are 14 RICNs in Ontario.

Small Community Hospital

Small community hospitals generally provide services to a single community and have a lower number of cases than a large hospital.