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Data demands a veritable sandstorm
"Sand; tiny, discrete particles with substance but basically without fixed structure, frequently accumulating in forms of great beauty or built into 'castles.' In this elemental form sand, and data, present great danger, able to blind us or even bury us." Walter J Hierholzer, Jr., MD
The metaphor is apt, as both sand and infection prevention data can be accumulated into elegant structures or piled on the overwhelmed IP with no regard for consequence. On the way to becoming a key new player in the shifting health care system, infection preventionists risk being overwhelmed by the growing demands for data collection.
An increasing number of state and federal regulators want to see infection rate data or have key process measures reported. There is still room for argument about how much these mandates improve quality, but regardless there is the immediate issue of the sheer manpower required to comply.
"We need to really support the infection preventionist, but also make sure consumers [and policy makers] understand this comes with a huge burden," Russell Olmsted, MPH, CIC, president of the Association for Professionals in Infection Control and Prevention said recently at the APIC conference in Baltimore. "We need to lessen that burden as part of our mission going forward."
Citing Hierholzer's quote above, Olmsted said, "I'm a little bit concerned that the amount of data is going to bury us, and blind us in terms of what we really have to do."
Indeed, at a time when IPs are poised to engage senior administration and take a more direct role in patient care, data mandates threaten to push them back in the silo, crunching numbers. The next critical requirement comes from none other than the Centers for Medicare and Medicaid Services (CMS), which will begin requiring in January 2012 the reporting of central line associated bloodstream infections in selected intensive care units (adult, pediatric, and neonatal ICUs), Olmsted reminded APIC attendees.
To make the collection of such data truly meaningful for infection prevention, it must be used for action, he said.
"Data for local action is very important, I think this happens at a grassroots level," he said. "We want to collect data and disseminate the results. I think we have seen some demonstration that the power of surveillance is sharing the findings, not the collection."
As this process is attempted, heretofore skeletal networks between many hospitals and public health systems are being fleshed out. In particular, the Centers for Disease Control and Prevention's National Healthcare Safety Network (NHSN), has stepped up to become the gold standard for surveillance data reporting, he noted.
"One thing that is positive about public reporting is that we have seen an explosion in the networking and opportunities for partnering with local, state public health and the CDC," he said. "It's an encouraging trend to see as we look at data management and information from patients. Use that sand appropriately, sift through that data and make it meaningful and practical for patients."
Another favorable trend is the implementation of electronic records and reporting technologies, which Olmsted hopes could eventually lead to labs freeing up IP time by directly reporting positive culture results. "I think we are on the brink of that," he said. "This is a trend I see emerging pretty quickly much more dependence on surveillance technology and automation as much as possible."
In the interim however, many IPs will have to do as best they can to expand the most demanding part of their jobs, according to Olmsted. "What's the biggest piece of the pie surveillance, almost 45% of our time," he said. "It's an incredible portion of our time."