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healthcare-associated Infections (HAI) program

Orange County Clostridium difficile Infection Prevention Collaborative

Region(s) served: Orange County, California
Project dates: June 2015 – June 2016

Together with the Orange County Health Care Agency (OCHCA), the HAI Program convened a Clostridium difficile infection (CDI) prevention collaborative among acute care hospitals and skilled nursing facilities in Orange County. Each facility participated in an onsite infection prevention assessment, committed to a facility-specific action plan, and engaged staff at quarterly in-person learning sessions. Forty healthcare facilities worked together to develop an interfacility transfer communication tool and process for Orange County facilities.

Goals and Objectives
Decrease CDI rates in local healthcare facilities through the following objectives:

  • Improve implementation of evidence-based CDI prevention strategies within all healthcare facilities
  • Improve care coordination to maintain appropriate infection prevention and control precautions for patients with CDI upon transfer to a receiving facility 
  • Strengthen surveillance through rapid identification of patients with CDI

Participating Facilities and Organizations:

  • 17 hospitals
  • 3 long-term acute care hospitals
  • 20 skilled nursing facilities
  • Health Services Advisory Group (HSAG)


  • ​​Participating facilities committed to action plans to improve antibiotic stewardship, environmental cleaning and disinfection programs, and interfacility communication
  • Healthcare facilities conducted self-assessments at the end of the collaborative year to review progress made and set goals for the post-collaborative period
  • Implemented a region-wide interfacility communication improvement process
  • Established a forum for local partners to build relationships, and share and discuss best practices

CDPH evaluated the effect of participation in the Orange County CDI Collaborative and found hospital-onset CDI incidence decreased by 4% per month among the hospitals that participated, whereas hospital-onset CDI incidence did not change among a comparison group of the San Francisco Bay Area hospitals during the same time period.


  • Preventing Clostridium difficile Infections Success Story 
  • Reduction in Clostridium difficile Infection Rates Following a Multifacility Prevention Initiative in Orange County, California: A Controlled Interrupted Time Series Evaluation

For more information on the Orange County CDI Prevention Collaborative, contact

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