The Maryland Statewide Prevention and Reduction Collaborative (SPARC) is a statewide quality improvement project engaging public health and academia to address the evolving needs of Maryland hospitals related to infection prevention and antibiotic stewardship. The Maryland Department of Health (MDH) works closely with the University of Maryland School of Medicine and Johns Hopkins University School of Medicine to coordinate SPARC while leveraging the expertise of NORC at the University of Chicago as its implementation contractor.

SPARC has established a peer-to-peer learning model that has resulted in knowledge sharing and meaningful improvements among acute care hospitals in Maryland. Through webinars and other engagement activities, SPARC has used this learning model to support Maryland hospitals in addressing a range of topics including:

• Hospital-onset Clostridioides difficile infections (CDI)
• COVID-19
• Central line-associated bloodstream infection (CLABSI)
• Antibiotic stewardship in sepsis
• Water management

SPARC’s efforts have produced meaningful results. After each initiative, the SPARC team assesses impacts and gathers lessons learned:

• An assessment of SPARC’s initiative on the prevention and reduction of CDI found that the initiative contributed to a reduction in CDI of 45% among 12 participating hospitals and a reduction in the Maryland Standardized Infection Ratio from 0.92 to 0.61.
• An assessment of the COVID-19-focused activities found that SPARC was an important source of information for hospitals managing dynamic COVID-19 guidance and policies.
• An assessment of SPARC’s sepsis intervention, which included site visits to 8 participating facilities, found that SPARC supported meaningful changes at facilities, and all sites were continuing intervention activities six months post-assessment.
• A post-assessment of SPARC’s water management initiative found that 93% of survey respondents reported implementing new or modified water management procedures, with 77% of these respondents attributing these changes to their participation in the initiative.
• Water management

SPARC utilizes qualitative interviews, pre- and post-assessments administered online, and focus groups to identify hospital needs and elicit feedback about the collaborative’s impact. SPARC is continuing its critical work to bolster antibiotic stewardship, support hospitals in their infection prevention practices, and confront emerging infectious diseases. Current SPARC activities include:

• Biweekly webinars covering relevant antibiotic stewardship and infection prevention topics.
• Office hours to allow participants to engage in a Q&A style conversation with experts.
• An initiative to promote antibiotic stewardship in urgent care settings.
• An initiative focused on surgical site infections and pediatric infection prevention.