New HAI data posted on CMS Hospital Compare
Patients can compare infection rates
New data recently posted on the Hospital Compare website of the Centers for Medicare & Medicaid Services (CMS) allows patients to see how their local hospitals are doing in preventing Clostridium difficile infections and methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections, the Centers for Disease Control and Prevention reports.
The data on health care associated infections (HAIs) were first reported to the CDC's National Healthcare Safety Network (NHSN) as part of the CMS Hospital Inpatient Quality Reporting (IQR) program. Under the IQR program, hospitals have a financial incentive to report the quality of their inpatient services by tying the reporting of designated quality measure data to their ability to be paid the full amount of the annual update to the Medicare inpatient payment rate. The HAI data and other quality information is then publically available on the CMS Hospital Compare website. (http://1.usa.gov/1bK1uk3)
The most recent numbers represent only the first quarter of 2013, and measurements of how hospitals are doing are expected to be more precise and provide a more complete picture as more information is collected over time, the CDC stated. The next update, representing six months of data, is scheduled for April 2014.
"The Hospital Compare website enables consumers to make informed choices and gives hospital leaders and their staff comparative information to help drive improvement," says Patrick Conway, MD, CMS chief medical officer and director of the Center for Clinical Standards and Quality. "Central line bloodstream infections have decreased more than 40% through transparency and improvement efforts, which has saved thousands of lives, and we hope to see the same positive results for these other two."
C. diff causes at least 250,000 hospitalizations and 14,000 deaths every year, and was recently categorized by the CDC as an "urgent threat" to patient safety. On the other hand, although still a common and severe threat to patients, invasive MRSA infections in healthcare settings appear to be declining. Between 2005 and 2011 overall rates of invasive MRSA dropped 31%. Success began with preventing central-line-associated bloodstream infections caused by MRSA, for which rates fell nearly 50% from 1997 to 2007, the CDC reported.
Some facilities that do not currently have a sufficient amount of data to collect may not have their infection ratios included in the Hospital IQR Program and subsequently, on the Hospital Compare website. For example, the number of C. diff and MRSA bloodstream infections in some smaller facilities might not provide enough information to calculate infection ratios until they report additional calendar quarters of data.
In accordance with the clinical quality measure used by CMS and CDC for laboratory-identified C. diff and MRSA bloodstream infections, the Hospital Compare website only reflects hospital-onset infections, which are defined as those detected after patients are hospitalized for a minimum of three days. Patients with community-acquired infections — a continuing problem with MRSA — are not included in the infection counts for the CMS quality measure.
Major teaching hospitals, hospitals with more than 400 beds and those with high community-onset rates continue to have the highest risk for C. diff and MRSA bloodstream infections, all of which is taken into account by risk adjustment when the clinical quality measure is calculated, the CDC explained. CDC and CMS encourage hospitals to participate in a variety of federal HAI prevention efforts, including those made available through state health departments (http://1.usa.gov/1cwA9Tv); CMS Quality Improvement Organizations (http://go.cms.gov/IZIlDW); and the Partnership for Patients Hospital Engagement Networks (http://partnershipforpatients.cms.gov/).