Mohamad G Fakih

Mohamad G Fakih
Ascension Health · Clinical & Network Services

MD, MPH

About

153
Publications
18,335
Reads
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Citations
Introduction
Mohamad Fakih, MD, MPH, is the Chief Quality Officer at Ascension. He leads the work on improving quality and safety across the continuum of care. His main focus is to standardize the process to improve outcomes and reduce patient harm. Particularly, he works on mitigating the risk for healthcare-associated infections, promoting antimicrobial stewardship, and optimizing sepsis management. Another area of focus is improving disease management in both acute care and ambulatory settings.
Additional affiliations
May 2019 - present
Ascension Health
Position
  • CEO
Description
  • Leads quality and clinical standardization.
September 2015 - April 2019
Ascension
Position
  • Managing Director
Description
  • Leads the Center of Excellence for Antimicrobial Stewardship and Infection Prevention
January 2003 - present
Wayne State University
Position
  • Professor (Full)
Education
September 1998 - October 2000
University of Michigan
Field of study
  • Health Management and Policy, Public Health
September 1987 - June 1991
American University of Beirut
Field of study
  • Medicine
September 1984 - June 1987
American University of Beirut
Field of study
  • Biology

Publications

Publications (153)
Article
Fifty years of evolution in infection prevention and control programs have involved significant accomplishments related to clinical practices, methodologies, and technology. However, regulatory mandates, and resource and research limitations, coupled with emerging infection threats such as the COVID-19 pandemic, present considerable challenges for...
Article
COVID-19 vaccination rates of a large health system reflected their respective service areas but varied by work role. Nurse vaccination rates were higher (56.9%) while nursing support personnel were lower (38.6%) than their communities (51.7%; P <0.001). Physician vaccination rates were highest (71.6%) and not associated with community vaccination...
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Background The COVID-19 pandemic has had a considerable impact leading to increases in healthcare-associated infections, particularly bloodstream infections (BSI). Methods We evaluated the impact of COVID-19 in 69 US hospitals on BSIs before and during the pandemic. Events associated with 5 pathogens (Staphylococcus aureus, Escherichia coli, Klebs...
Article
Background Urine cultures are nonspecific for infection and often lead to misdiagnosis of urinary tract infection and unnecessary antibiotics. Diagnostic stewardship is a set of procedures that modifies test ordering, processing, and reporting in order to optimize diagnosis and downstream treatment. This study aimed to develop expert guidance on be...
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Background The associated mortality with COVID-19 has improved compared with the early pandemic period. The effect of hospital COVID-19 patient prevalence on COVID-19 mortality has not been well studied. Methods We analysed data for adults with confirmed SARS-CoV-2 infection admitted to 62 hospitals within a multistate health system over 12 months...
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This consensus statement by the Society for Healthcare Epidemiology of America (SHEA) and the Society for Post-Acute and Long-Term Care Medicine (AMDA), the Association for Professionals in Epidemiology and Infection Control (APIC), the HIV Medicine Association (HIVMA), the Infectious Diseases Society of America (IDSA), the Pediatric Infectious Dis...
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Background The coronavirus disease 2019 (COVID-19) pandemic has had a considerable impact on US hospitalizations, affecting processes and patient population. Methods We evaluated the impact of COVID-19 pandemic in 78 US hospitals on central line associated bloodstream infections (CLABSI) and catheter associated urinary tract infections (CAUTI) eve...
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The extensive use of the urinalysis for screening and monitoring in diverse clinical settings usually identifies abnormal urinalysis parameters in patients with no suspicion of urinary tract infection, which in turn triggers urine cultures, inappropriate antimicrobial use, and associated harms like Clostridioides difficile infection. We highlight h...
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Background: Interventions to reduce unnecessary device use may select a higher-risk population, leading to a paradoxical increase in SIR for some high-performing facilities. The standardized utilization ratio (SUR) adjusts for device use for different units and facilities. We evaluated the performance of a population SIR (pSIR) metric compared to d...
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Background: Acute-care hospitals in the United States are required to submit 6 healthcare-associated infection (HAI) metrics to the CMS for reporting and performance purposes prior to payment. We examined the association between HAI rate trends and hospital-onset bloodstream infection (HO-BSI) rate trends across a large, multihospital health system...
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Importance While current reports suggest that a disproportionate share of US coronavirus disease 2019 (COVID-19) cases and deaths are among Black residents, little information is available regarding how race is associated with in-hospital mortality. Objective To evaluate the association of race, adjusting for sociodemographic and clinical factors,...
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Overcoming COVID-19: Addressing the Perception of Risk and Transitioning Protective Behaviors to Habits - Mohamad G. Fakih, Lisa Sturm, Rand R. Fakih
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Background Staphylococcus aureus is a common pathogen that is implicated with both community and healthcare-associated infections. S. aureus infections lead to sepsis and bacteremia, and are associated with considerable morbidity and mortality despite available antimicrobial therapy. Methods Utilizing a clinical decision support system, patients w...
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Background Hospitalized patients with bacteriuria are often identified based on positive urine cultures during the workup of urinary tract infection (UTI). However, the frequency of obtaining urine cultures varies between hospitals and may affect the detection of asymptomatic bacteriuria and symptomatic UTI. Methods We evaluated the frequency of u...
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Background Clostridioides difficile infections (CDIs) are the most prevalent healthcare-associated infection in the U.S. Of all CDIs, most are related to healthcare exposures and are potentially preventable by reducing unnecessary antibiotic use and interrupting patient-to-patient transmission of CDI. Methods The adult SAARs for 4 antimicrobial ag...
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Background Overuse of fluoroquinolones has been associated with increased rates of Clostridioides difficile infections, MRSA, and resistant Gram-negative infections due to selective pressure on normal flora. In addition, the FDA has issued several safety alerts regarding systemic use of fluoroquinolone antibiotics due to concerns for serious advers...
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Background Compliance with evidence-based treatment bundles in patients with sepsis can lead to improved survival in persons with sepsis or septic shock. A way to ensure the adoption of best practices is the early use standardized order sets based on suspected source of infection. Methods The patient population was built by connecting electronic h...
Article
Laboratory-identified bloodstream infections (LAB-ID BSIs) in recently discharged patients are likely to be classified as healthcare-associated community-onset (HCA-CO) infections, even though they may represent hospital-onset (HO) infections. A review of LAB-ID BSIs among patients discharged within 14 days revealed that 109 of 756 cases (14.4%) we...
Article
Background The device standardized infection ratio (SIR) is used to compare unit and hospital performance for different publicly reported infections. Interventions to reduce unnecessary device use may select a higher-risk population, leading to a paradoxical increase in SIR for some high-performing facilities. The standardized utilization ratio (SU...
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Full-text available
BACKGROUND In this changing landscape of healthcare, Infection Prevention (IP) programs need to demonstrate their value to their institutions. One way to do this is through the reduction of healthcare associated infections (HAI). This improves patient outcomes and can also provide value through the avoidance of hospital acquired condition (HAC) pen...
Article
Diagnosis of urinary tract infections: need for a reflective rather than reflexive approach - Volume 40 Issue 7 - Mohamad G. Fakih, Sonali D. Advani, Valerie M. Vaughn
Article
Catheter-associated urinary tract infection (CAUTI) has long been considered a preventable healthcare-associated infection. Many federal agencies, the Centers for Medicare and Medicaid Services (CMS), and public and private healthcare organizations have implemented strategies aimed at preventing CAUTIs. To monitor progress in CAUTI prevention, the...
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Background The National Healthcare Safety Network (NHSN)’s Targeted Assessment for Prevention (TAP) Strategy is a framework for quality improvement that offers a focused approach to infection prevention. The cumulative attributable difference (CAD) is used as a prioritization metric to identify areas with the highest burden of excess infections. Th...
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Background The device standardized infection ratio (SIR) has been used to compare units’ and hospitals’ performance for different publicly reported infections. Interventions to reduce unnecessary device use may select a higher risk population that is not accounted for in the current risk adjustments, leading to a paradoxical increase in SIR for fac...
Article
Full-text available
Background Laboratory-identified bloodstream infections (LAB-ID-BSI) are classified as community onset (CO) if blood culture (BC) is collected within 3 days after facility admission and hospital onset if ≥4 days. This classification is often based on a computer-generated subtraction of the day of admission from day of onset. This method may miss re...
Article
We compared interventions to improve urinary catheter care and urine culturing in adult intensive care units of 2 teaching hospitals. Compared to hospital A, hospital B had lower catheter utilization, more compliance with appropriate indications and maintenance, but higher urine culture use and more positive urine cultures per 1,000 patient days.
Article
Antimicrobial Stewardship and Infection Prevention—Leveraging the Synergy: A Position Paper Update - Volume 39 Issue 4 - Mary Lou Manning, Edward J. Septimus, Elizabeth S. Dodds Ashley, Sara E. Cosgrove, Mohamad G. Fakih, Steve J. Schweon, Frank E. Myers, Julia A. Moody
Article
Cambridge Core - Infectious Disease - Practical Healthcare Epidemiology - edited by Ebbing Lautenbach
Article
Full-text available
Of 500 hospital-onset Staphylococcus aureus bacteremia events (58% methicillin-susceptible S. aureus [MSSA]; 42% methicillin-resistant S. aureus [MRSA]), we found no significant differences in S. aureus bacteremia rates between medium-sized and large hospitals. However, the proportion of S. aureus bacteremia caused by MSSA was greater in medium-siz...
Article
To systematically improve the appropriateness of antibiotic prescribing, antimicrobial stewardship programs have been developed. There is a paucity of literature examining how pharmacists perform antimicrobial stewardship using a clinical decision support system in a hospital setting. The purpose of this qualitative study was to develop a model exp...
Article
BACKGROUND Urinary catheters, many of which are placed in the emergency department (ED) setting, are often inappropriate, and they are associated with infectious and noninfectious complications. Although several studies evaluating the effect of interventions have focused on reducing catheter use in the ED setting, the organizational contexts within...
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Background Currently, publicly reported infections include a few types of events, and do not provide a comprehensive picture on overall infection prevention practices. Hospital onset bloodstream infection (HOBSI), regardless of source, reflects invasive infection from an at risk patient population in inpatient healthcare settings. Methods Using on...
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Background Hospital Onset (HO) Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia is publicly reported and tied to the Hospital-Acquired Conditions Reduction program. It reflects a surrogate of risk of infection of MRSA invasive disease in the hospital setting, and reported as a standardized infection ratio that adjusts for admission MRS...
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Background Inappropriate Antimicrobial use, its associated resistance and suboptimal patient outcomes are important quality and safety concerns. Antimicrobial stewardship programs (ASP) can help reduce the risk of development of multi-drug resistant organisms, and Clostridium difficile infections. The Centers for Disease Control and Prevention (CDC...
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Background Penicillin allergy is the most common antibiotic allergy noted within medical records, and its inaccurate reporting leads to increased use of alternative antibiotics that may be less effective, broader in spectrum, more toxic, and costly. Methods We retrospectively reviewed the reported allergies to penicillin in patients cared for at 1...
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Background Antibiotics are frequently prescribed among senior living residents, with the over diagnosis of infections playing a significant problem. Elderly are vulnerable to the harms of inappropriate antibiotic use. Methods We evaluated the use of systemic antibiotics, the diagnosis of facility-onset urinary tract infection (based on McGeer’s cr...
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BACKGROUND The National Healthcare Safety Network (NHSN) catheter-associated urinary tract infection (CAUTI) definition was revised as of January 2015 to exclude funguria and lower bacteriuria levels. We evaluated the effect of the CAUTI definition change on NHSN-defined central-line–associated bloodstream infection (CLABSI) outcomes. METHODS We c...
Article
div class="title">Improving the Culture of Culturing: Critical Asset to Antimicrobial Stewardship - Mohamad G. Fakih, Riad Khatib
Article
Background: The standardized infection ratio (SIR) evaluates individual publicly reported health care-associated infections, but it may not assess overall performance. Methods: We piloted an infection composite score (ICS) in 82 hospitals of a single health system. The ICS is a combined score for central line-associated bloodstream infections, c...
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Full-text available
Response to Allen-Bridson and Pollock - Volume 37 Issue 9 - M. Todd Greene, Mohamad G. Fakih, Sanjay Saint
Article
Candidemia rate and species distribution vary according to the type of patients, country of origin and antifungal prophylaxis use. To present current candidemia epidemiological trends. A retrospective examination of candidemia in adults (≥18 years-old) hospitalised from 2007 to 2015. Cases were identified through the microbiology laboratory. Candid...
Article
Background Catheter-associated urinary tract infection (UTI) is a common device-associated infection in hospitals. Both technical factors — appropriate catheter use, aseptic insertion, and proper maintenance — and socioadaptive factors, such as cultural and behavioral changes in hospital units, are important in preventing catheter-associated UTI....
Article
The Centers for Disease Control and Prevention recently updated the surveillance definition of catheter-associated urinary tract infection to include only urine culture bacteria of at least 1×10 5 colony-forming units/mL. Our findings suggest that the new surveillance definition may fail to capture clinically meaningful catheter-associated urinary...
Article
Catheter-associated urinary tract infection (CAUTI) is considered a reasonably preventable event in the hospital setting, and it has been included in the US Department of Health and Human Services National Action Plan to Prevent Healthcare-Associated Infections. While multiple definitions for measuring CAUTI exist, each has important limitations, a...
Article
Background: Obtaining a specimen for urine culture is a key element in evaluating for catheter-associated urinary tract infections (CAUTIs). Evaluating nurses' knowledge regarding appropriate reasons and methods to obtain urine culture specimens are the first steps to improving practice. Methods: Nurses at 5 hospitals completed a 40-question sur...
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Ebola as a Test for Emerging Pathogen Preparedness: The Critical Role of Health Systems in Ensuring Support - Volume 36 Issue 6 - Mohamad G. Fakih, Michelle Heavens, Ann Hendrich
Article
Blood cultures are often submitted as series (two to three sets per 24 hours) to maximize sample recovery. We assessed the actual benefit of additional sets. Blood cultures submitted from adults (≥18 years old) over 1 year (1 February 2012 to 31 January 2013) were examined. The medical records of patients with positive cultures were reviewed. Cultu...