Definition of a model for hospital environmental safety through the Hospital Hygiene Unit activities: findings from a Budget Impact Analysis to estimate savings due to avoided infection in an Italian teaching hospital

Background Targeted environmental monitoring is needed to obtain hospital patients safety. For this reason, Hospital Hygiene Unit (HHU) of Gemelli Teaching Hospital (GTH) periodically analyzes and inspects 10 healthcare production processes (HPP) and then expresses, in accordance with scientific evidences and current legislation, a report of healthcare compliance or not, in order to protect both patient and healthcare personnel. Aim of this study is to carry out an economic assessment in order to simulate the potential financial benefits due to prevention of nosocomial infection, thanks to actions of environmental control and safety implemented by HHU. Methods We performed a Budget Impact Analysis (BIA) for the HPP (from 2011 to 2013) making a prediction for 2014 and 2015 supposing 3 efficiency scenarios of HHU: in the first scenario the efficiency of HHU keeps constant, increases in the second, due to increased investment in environmental monitoring, and decreases in the third, due to decreased investment. The variables used to run BIA are annual number of HPP in GTH from 2011 to 2013, number of samples controlled by HHU and the resulting non-compliance between 2011 and 2013, attack rate and unit cost of nosocomial infection reported in scientific literature. Results BIA results show in 2015 a cost-saving of 30.2% versus to potential financial impact of E1,172,533 in 2011, due to infective adverse events, in scenario of constant efficiency. In scenario of increased efficiency cost-saving reaches 31,5% and drops to 28.8% in scenario of decreased efficiency. Conclusions This study shows how, in a well structured organization such as GTH, it’s essential implementing the control and safety procedures and investing in environmental monitoring in order to optimize Healthcare Infections Risk Management and ensure the saving of financial resources. Even more in a period of strong focus on economic sustainability of hospital care, these results concretely represent the cost-benefit of HHU activities not only for patients safety but also for sustainability of healthcare funds provider. Further evaluations are needed to highlight also potential savings arising from prevention of non infective adverse events. Key message Targeted environmental monitoring aimed at nosocomial infection risk assessment and management represents an effectiveness and cost-saving tool.