# P-2030. Streamlining Root Cause Analysis of Healthcare-Associated Infections and Outbreaks Using a Mobile App–Based Digital Platform: A Quality Improvement Study in Infection Prevention and Control

## TL;DR

A mobile app-based platform improved the speed and effectiveness of infection investigations in a hospital, reducing recurrence and boosting user satisfaction.

## Contribution

A mobile app-based digital platform for root cause analysis of healthcare-associated infections was developed and shown to significantly improve response times and outcomes.

## Key findings

- Median RCA closure time decreased from 12.5 days to 4.2 days with the mobile app.
- Corrective action implementation rates increased from 57.6% to 88.9%.
- Event recurrence within 60 days dropped from 19.2% to 3.7%.

## Abstract

Timely Root Cause Analysis (RCA) of healthcare-associated infections (HAIs) is essential for effective infection control. This study evaluated a mobile app–based RCA platform to improve response time, implementation, and recurrence tracking in a tertiary care hospital.

This prospective, before-and-after quality improvement study was conducted from January to June 2024 in a 650-bed tertiary hospital in South India. The mobile app integrated event-specific RCA templates (CLABSI, CAUTI, SSI, VAP), timeline tracking, task assignment, escalation alerts, and digital signatures. RCA data from July to December 2023 (paper-based) served as controls. Outcomes included median time to RCA closure, corrective action completion rate, event recurrence within 60 days, and user engagement and satisfaction. Statistical analyses included Kaplan-Meier survival curves, Cox proportional hazards regression, and chi-square tests.

A total of 53 RCA events were included (control: 26; intervention: 27). The Kaplan–Meier survival analysis showed a significantly faster time to RCA closure in the intervention group (log-rank p < 0.001). Median RCA closure time was reduced from 12.5 days to 4.2 days. Using Cox proportional hazards regression, digital RCA implementation was associated with a 3.08-fold increased likelihood of timely closure (Hazard Ratio: 3.08, 95% CI: 1.85–5.13, p < 0.001), after adjusting for infection type, unit, and severity. Subgroup analysis demonstrated the greatest time reduction for CLABSI-related RCAs (median: 14 to 3.5 days, p < 0.01). Corrective action implementation rates improved from 57.6% (15/26) in the control group to 88.9% (24/27) in the intervention group (χ² = 7.05, p = 0.008). The event recurrence rate within 60 days dropped significantly from 19.2% (5/26) to 3.7% (1/27) (χ² = 4.89, p = 0.026). User satisfaction was high, with a mean System Usability Scale (SUS) score of 85.6 ± 6.3 and a Net Promoter Score (NPS) of +54. Task acceptance within 48 hours improved from 46% to 91% post-implementation (p < 0.001).

The mobile RCA platform led to significantly faster investigation cycles, improved accountability, and reduced infection recurrence. This digital framework can transform RCA implementation in IPC programs, especially in LMICs.

All Authors: No reported disclosures