Since 2002, 4 states have enacted legislation that requires health care organizations
to publicly disclose health care–associated infection (HAI) rates. Similar legislative
efforts are underway in several other states. Advocates of mandatory public reporting
of HAIs believe that making such information publicly available will enable consumers
to make more informed choices about their health care and improve overall health care
quality by reducing HAIs. Further, they believe that patients have a right to know
this information. However, others have expressed concern that the reliability of public
reporting systems may be compromised by institutional variability in the definitions
used for HAIs, or in the methods and resources used to identify HAIs. Presently, there
is insufficient evidence on the merits and limitations of an HAI public reporting
system. Therefore, the Healthcare Infection Control Practices Advisory Committee (HICPAC)
has not recommended for or against mandatory public reporting of HAI rates. However,
HICPAC has developed this guidance document based on established principles for public
health and HAI reporting systems. This document is intended to assist policymakers,
program planners, consumer advocacy organizations, and others tasked with designing
and implementing public reporting systems for HAIs. The document provides a framework
for legislators, but does not provide model legislation. HICPAC recommends that persons
who design and implement such systems 1) use established public health surveillance
methods when designing and implementing mandatory HAI reporting systems; 2) create
multidisciplinary advisory panels, including persons with expertise in the prevention
and control of HAIs, to monitor the planning and oversight of HAI public reporting
systems; 3) choose appropriate process and outcome measures based on facility type
and phase in measures to allow time for facilities to adapt and to permit ongoing
evaluation of data validity; and 4) provide regular and confidential feedback of performance
data to healthcare providers. Specifically, HICPAC recommends that states establishing
public reporting systems for HAIs select one or more of the following process or outcome
measures as appropriate for hospitals or long-term care facilities in their jurisdictions:
1) central-line insertion practices; 2) surgical antimicrobial prophylaxis; 3) influenza
vaccination coverage among patients and healthcare personnel; 4) central line-associated
bloodstream infections; and 5) surgical site infections following selected operations.
HICPAC will update these recommendations as more research and experience become available.
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© 2005 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
