Bookmark & Share

Favorites	Google
Digg	Del.icio.us
Twitter	Facebook

>> More...

A new report from the Government Accountability Office (GAO) suggests that current methods for collecting data on health care-associated infections (HAI) are disparate and ineffective, resulting in an inaccurate assessment of infection-control problems at ambulatory surgical centers (ASCs), Modern Healthcare reports. Currently, the U.S. Department of Health and Human Services (HHS), the Centers for Medicare and Medicaid Services (CMS) and two professional organizations collect HAI data from ASCs, including HAI rates and data on the implementation of infection control measures. The researchers note, however, that such data is not standardized across agencies and is often collected from "narrowly defined subsets of ASCs." In an effort to better standardize HAI outcomes data, a recent CDC pilot study tested innovations aimed at obtaining nationally representative infection-control data. Specifically, the pilot examined the application of two innovations, a CDC-developed infection control assessment tool and direct observation by the surveyor of a single patient's care from hospital admission to discharge. Used together, the innovations allowed surveyors to identify serious lapses in CDC-recommended infection control practices that would have otherwise gone undetected using existing CMS standard surveys. Commenting on the pilot study, a CMS official told the GAO that the agency would consider making changes to its standard survey process, but indicated that it was not feasible to use the same assessment tool to collect standardized quantitative data on the extent of compliance with specific infection control practices. In addition, the official notes that, even if the agency were to continue collecting data via the tool, the data would not be nationally representative because ASCs are not randomly surveyed. Rather, surveys are based on the perceived risk for quality issues and the time elapsed since the ASC was last surveyed. Given that an accurate nationwide estimate of HAIs and infection control lapses must involve data from a nationally representative random sample of ASCs, the GAO recommends that the HHS Acting Secretary develop and implement a written plan using the data collection instrument and methodology tested in the CMS pilot to conduct recurring periodic surveys of randomly selected ASCs. The GAO contends that following the recommendations would allow CMS to generate national estimates that provide a more accurate picture of the extent of HAIs nationwide, as well as identify lapses in infection control practices among ASCs that are most likely to jeopardize patient health. CMS concurred with the recommendation (Robeznieks, Modern Healthcare, 3/28/09 [subscription required]; GAO report, 3/27/09).