Highlights
- •An infection composite score of the 6 publicly reported health care–associated infections is proposed.
- •The infection composite score adjusts the individual standardized infection ratios into a group performance.
- •The infection composite score may help evaluate general performance of hospitals in preventing infection.
- •Large systems, state health departments and hospital associations, and quality improvement networks may use the infection composite score to help them identify hospitals that require further support to reduce infection.
Background
The standardized infection ratio (SIR) evaluates individual publicly reported health
care–associated infections, but it may not assess overall performance.
Methods
We piloted an infection composite score (ICS) in 82 hospitals of a single health system.
The ICS is a combined score for central line–associated bloodstream infections, catheter-associated
urinary tract infections, colon and abdominal hysterectomy surgical site infections,
and hospital-onset methicillin-resistant Staphylococcus aureus bacteremia and Clostridium difficile infections. Individual facility ICSs were calculated by normalizing each of the 6
SIR events to the system SIR for baseline and performance periods (ICSib and ICSip, respectively). A hospital ICSib reflected its baseline performance compared with system baseline, whereas a ICSip provided information of its outcome changes compared with system baseline.
Results
Both the ICSib (baseline 2013) and ICSip (performance 2014) were calculated for 63 hospitals (reporting at least 4 of the
6 event types). The ICSip improved in 36 of 63 (57.1%) hospitals in 2014 when compared with the ICSib in 2013. The ICSib 2013 median was 0.96 (range, 0.13-2.94) versus the 2014 ICSip median of 0.92 (range, 0-6.55). Variation was more evident in hospitals with ≤100
beds. The system performance score (ICSsp) in 2014 was 0.95, a 5% improvement compared with 2013.
Conclusions
The proposed ICS may help large health systems and state hospital associations better
evaluate key infectious outcomes, comparing them with historic and concurrent performance
of peers.
Key Words
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References
- National Healthcare Safety Network report, data summary for 2013, Device-associated Module.Am J Infect Control. 2015; 43: 206-221
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Article Info
Publication History
Published online: September 16, 2016
Footnotes
Conflicts of Interest: All authors report no conflicts of interest. M.G.F. reports receiving support for involvement in the Ascension Health Hospital Engagement Network effort to prevent health care–associated infections, previously for the On the CUSP: Stop CAUTI initiative, and for the Michigan Health and Hospital Association Hospital Engagement Network to reduce catheter-associated urinary tract infections.
Identification
Copyright
© 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
