Clostridium Difficile (C. difficile) is a bacteria-related gastrointestinal infection that is caused (etiology) by the use of antibiotics therapy or exposure to the C. difficile spores (Swartz, 2013). According to published reports compiled by the California Department of Public Health (CDPH), National Safety Network (NHSN), and the Center for Disease Control Prevention (CDC), the rate of CDI have a major financial impact (costs associated with medical management of CDI) on health care institution across the United States. CDI is major concern for hospital administrators and patients at Sharp Grossmont Hospital (SGH) and other in hospitals within the Sharp Healthcare Network (SHN). According to data released by CPDH and the CDC, from January to December 2012 three hospitals within the (SHN) reported 136 new cases of CDI. Statistical data also show that 20,000 to 34,000 patients were admitted or readmitted to the hospitals for recurrent complications related to CDI such as electrolyte imbalance, nutrition deficits, and systemic bacteremia (CDPH, 2013).
Fecal Microbiota Transplantation Program
According to Rohike and Stollman (2012), fecal microbiotic transplantation (FMT) first was used in 1958, as a treatment option for patients with antibiotic-associated diarrhea. However, the procedure was rarely performed or used in medical practice in the United States and in other countries. Because of increasing incidences and severity of CDI, FMT has gain acceptance as a quick and inexpensive treatment option (Brandt, 2012) for recurrent CDI. FMT involves the instillation of fecal material from a healthy individual into the intestinal track of a patient with recurrent CDI. Fecal material can be administered via endoscopy and colonoscopy. Additionally, fecal material can also be administered through a nasogastric tube (NGT) or by the insertion of retention enema. (Mitchell, Shropshire, and Ruel, 2013). The FMT procedure can be performed in an outpatient or inpatient care environment. The goal of FMT is to restore normal flora colonization in a patient with CDI. FMT is highly effective in eradicating CDI and restoring normal intestinal flora. Research studies conducted by (Pathak, Patel, and Wickremesinghe,) concluded that FMT has a >90 % primary and a >97% secondary cure rate. The researchers found defined primary and secondary cure rate as (1) as the alleviation of CDI and related symptoms within 90 days of FMT and (2) the alleviation of CDI and related symptoms with additional vancomycin therapy without repeating the FMT procedure.
Health care organization receives financial reimbursement from third party payers and from the Centers for Medicare and Medicaid Services (CMS) for performing FMT procedures. According to a recent article in the American Gastroenterological Association (AGA) newsletter (2014), “CMS has created a new HCPCS code, G0455, which includes the work of both preparation and instillation of fecal microbiota by any...