Safe Healthcare

Hosted by CDC’s Division of Healthcare Quality Promotion

Add this to...
Añadir en...
Favorites
Delicious
Digg
Google Bookmarks

CMS Rule: Shining the spotlight on hospital acquired infections – Part 5

Categories: Clostridium difficile, Healthcare-associated infections, MRSA

August 9th, 2010 6:40 am ET - .

Lisa McGiffert

Guest Author — Lisa McGiffert
Director, Consumer’s Union Safe Patient Project

Is your hospital doing a good job protecting patients from developing infections during treatment? For years, patients have been left in the dark about this important indicator of hospital safety even though these infections are associated with nearly 100,000 deaths annually.

Nancy Oliver, of Cincinnati, Ohio, wished she had known more about her hospital’s infection rates. Nancy’s father was expected to make an excellent recovery following heart surgery but ended up developing a MRSA infection in his surgical site. Later he acquired a C-difficile infection, went into septic shock and died. “We miss my Dad every day,” says Oliver who has become an active patient safety advocate.

Next year, consumers across the country finally will be able to start checking their hospital’s infection prevention track record thanks to new regulations adopted as part of the landmark health care reform law.

The regulations build on the successful efforts of patient safety advocates working with Consumers Union over the past seven years to push states to adopt hospital infection reporting laws. Twenty seven states have done so and 19 have issued reports so far that disclose this critical information to the public.

Consumers can already check the Hospital Compare web site to find out how well hospitals follow procedures proven to reduce surgical site infection risks. But soon the public in all 50 states will be able to see whether their hospital’s prevention efforts are working.

The new regulations will make central line associated bloodstream infection rates in intensive care units, including neonatal intensive care units, available on Hospital Compare next year and surgical site infection rates in 2012. That’s a good start but it should be just the beginning.

Patients have a right to know about other hospital-acquired infection rates, including those caused by MRSA and C.difficile, and urinary tract infections. These additional infections are targeted for improvement by a federal healthcare-associated infection action plan. The public should be able to see if the action plan’s prevention targets for these infections are being met.

Armed with infection rate information, consumers will be able to make more informed decisions about where to go for the care they need. And disclosing this information to the public is a powerful motivator for hospitals to improve care and keep patients safe.

For Nancy Oliver and the countless others who have lost loved ones to hospital-acquired infections, making infection rates public is long overdue.

___________
Lisa McGiffert is the Director of Consumers Union’s Safe Patient Project. Follow the campaign on Twitter @CUSafePatient Consumers Union is the nonprofit publisher of Consumer Reports.

3 Comments - Read more

CMS Rule: A Bold Step, But Just One Step Toward Eliminating HAIs – Part 4

Categories: CLABSI, Healthcare-associated infections, NHSN

August 5th, 2010 9:32 am ET - .

Neil Fishman, M.D.

Guest Author – Neil Fishman, M.D.
President of the Society for Healthcare Epidemiology of America (SHEA)
Director of the Department of Healthcare Epidemiology and Infection Control and Director of the Antimicrobial Management Program for the University of Pennsylvania Health System.

With the announcement of the new CMS rule last week, the United States has taken an important first step toward creating a national public reporting system that can be used to guide and monitor our efforts to eliminate healthcare-associated infections (HAIs). To its credit, CMS responded to the recommendations of experts in the field (see SHEA FY 2011 IPPS Comments June 2010) and based the rule upon reporting to the CDC National Healthcare Safety Network (NHSN). This system uses a set of standardized definitions across all acute care settings and data is collected by individuals trained in infection prevention and control. While the rule helps establish a strong base for public transparency, it remains a smaller achievement in comparison to initiatives in other developed countries such as France. Here in the U.S., we must:

Look beyond the ICU. Recognize that CLABSIs do not just occur in the ICU. Indeed, the majority of these infections may occur outside the intensive care setting and should also be reported.

6 Comments - Read more

CMS Rule: Infection Preventionists Key to Reporting Success – Part 3

Categories: CLABSI, Healthcare-associated infections, NHSN

August 5th, 2010 9:30 am ET - .

Russell N. Olmsted, MPH, CIC

Guest Author – Russell N. Olmsted, MPH, CIC
President-Elect, Association for Professionals in Infection Control and Epidemiology (APIC)
Epidemiologist in Infection Prevention & Control Services, St. Joseph Mercy Health System (SJMHS)

The new Centers for Medicare and Medicaid rule is consistent with APIC’s position that better transparency will lead to better health outcomes, and that is good for patients. The use of CDC’s National Healthcare Safety Network ensures more valid and reproducible outcome data as compared with sole reliance on administrative data. Using Hospital Compare will give consumers everywhere easier access to more reliable data about their healthcare facilities.

Inside healthcare facilities, infection preventionists will play a critical role in meeting the requirements of this new change. APIC is a strong supporter of NHSN; we believe it is the best currently available method to establish a meaningful national HAI reporting system because it relies on epidemiologically sound, surveillance data. And now CMS will use those same data for payment purposes.

2 Comments - Read more

CMS Rule: A Monumental Step Forward for Patient Safety and Transparency – Part 2

Categories: CLABSI, Healthcare-associated infections, NHSN, State HAI Prevention

August 2nd, 2010 2:29 pm ET - .

Peter J. Pronovost, M.D., PhD., FCCM

Guest Author – Peter J. Pronovost, M.D., PhD., FCCM
Professor, The Johns Hopkins University
Anesthesia & Critical Care Medicine, Health Policy & Management
Director, The Quality and Safety Research Group

On July 30, the Centers for Medicare and Medicaid Services (CMS) took a bold step that will provide consumers with important information about their risks in hospitals. With the new CMS rule, we have, for the first time, a trifecta: robust interventions known to reduce infections, payment policies to reward hospitals for reporting and reducing infections, and transparent public reporting of infections using valid data.

Building upon decades of research, all hospitals now have the ability to nearly eliminate these infections, making CLABSI the polio campaign of the 21st century. We have an approach that works — using an intervention that includes a simple checklist of best practices; measuring and reporting infection rates to the clinical teams and administrators; and improving teamwork among doctors, nurses and hospital leaders, the Johns Hopkins Hospital virtually eliminated these infections. With support from the Agency for Health Care Research and Quality (AHRQ), this Hopkins program reduced CLABSI by 66% in 103 Michigan intensive care units. State Hospital Associations, CMS Quality Improvement Organizations (QIOs), and state health departments, with support from CDC, work with our national team and local providers to implement the program state-by-state. We get additional support from professional societies, consumer groups, and business coalitions. Working together, linked to a common measurable goal, we will reduce these infections.

1 Comment - Read more

Today’s CMS Rule: A Major Step for HAI Reporting – Part 1

Categories: CLABSI, Healthcare-associated infections, NHSN, State HAI Prevention

July 30th, 2010 1:59 pm ET - .

Michael Bell, MD

-Mike Bell, MD
Deputy Director,
Division of Healthcare Quality Promotion, CDC

It’s a new day in our efforts to eliminate healthcare-associated infections (HAIs). A rule released today by the Centers for Medicare & Medicaid Services (CMS) lays out HAI reporting requirements for Medicare eligible hospitals that participate in CMS’ pay-for-reporting program. More than 3,500 hospitals will soon use CDC’s National Healthcare Safety Network (NHSN) to report central line-associated bloodstream infection (CLABSI) and surgical site infection (SSI) data to CMS. In turn, the agency will post the information on the HHS publicly accessible Hospital Compare Web site.

The release from CMS today is yet another sign that HAIs are recognized as a significant measure of healthcare quality. It is encouraging to see CMS build upon its work in preventing healthcare-acquired conditions, including HAIs.

So, what does this mean in practice?

For healthcare facilities – it connects financial incentives to HAI reporting. In other words, facilities that report will be recognized and rewarded for their efforts. We expect that this change will fuel existing momentum toward HAI prevention and elimination programs already happening within healthcare facilities across the country.

For patients – it is an excellent way to see how their hospital is doing on several quality of care issues, including preventing infections. It will be the first time patients from all states can view the infection data from their local hospitals. This information can serve as a discussion point between patients and their healthcare providers.

12 Comments - Read more