- The CMS caves in to special interests subsequently apologizing for suggesting that Hospitals be accountable by reporting HAI’s.
- Mandatory Reporting in France and Britain found to be effective.
- In Britain the government provides its citizens the opportunity to search on line and find the infection rate — lucky them — they have the best chance to survive based on knowledge.
- In the U.S. we get to roll the dice because reporting is just too difficult for hospitals and we have to be considerate of their resources! not our lives.
10 May 2010
WASHINGTON, May 10 — The Health Forum issued the following news release:
Responding to concerns about imposing a “severe burden” on hospitals, the Centers for Medicare & Medicaid Services May 7, 2010, notified hospitals that it has reversed course and no longer is requiring them to submit to the Buccaneer Data Systems Clinical Data Abstraction Center data that theypreviously reported to the Centers for Disease Control and Prevention on Methicillian-resistant Staphylococcus aureus.
MRSA is a bacterium responsible for several difficult-to-treat infections in patients. CMS’ Office of Clinical Standards and Quality withdrew its April 29 requirement for the data, which it said was intended to help estimate the accuracy of MRSA data reported to CDC and to assess the “accuracy of medical record-abstracted information at a hospital level, relative to national rates collected in other initiatives.”
In its May 7 letter, the agency said it is dropping the requirement to send the data, after listening to hospitals and “national and state association feedback about the severe burden to hospitals.” CMS said hospitals that submit the data voluntarily will be reimbursed for their costs.
“We sincerely apologize for any inconvenience that results from this request, and kindly request that your hospital continue to work collaboratively with your [Quality Improvement Organization] partner in improving MRSA rates and overall patient safety,” CMS said. “We appreciate CMS’ responsiveness to the concerns raised,” said Nancy Foster, AHA vice president for quality and patient safety. “We are glad that CMS’ decision will allow those participating in this project to stay focused on that very important goal.”
ARE YOU KIDDING ME?
Researchers evaluating France’s national infection control program for healthcare facilities found significant decreases in the rates of healthcare-associated infections (HAIs) since 2004. The drop in HAIs, including MRSA and surgical site infections, could be attributed to important changes in the national infection control system. France’s national, regional and local coordinating centers have been reorganized to help facilities throughout the country comply and conform with mandatory public reporting requirements and key program objectives. The findings were presented at the Fifth Decennial International Conference on Healthcare-Associated Infections.
“The French National Program demonstrates the value of a national standard reporting system for healthcare-associated infections,” said Neil Fishman, MD, President of SHEA. “As seen in this study, public transparency can lead to a culture of accountability and continuous healthcare quality improvement. Having accurate data for action drives progress toward the elimination of HAIs, but we need the appropriate infrastructure to achieve these goals.”
Laetitia May-Michelangeli, MD Ministry of Health & Sports (MoH), and Christian Brun-Buisson, MD, chair of the national infection control program at Hospital Henri Mondor in Paris, worked with a team of infection control experts to evaluate the impact of the national program to reduce HAIs. Researchers evaluated aggregated data compiled from mandatory annual reports by national surveillance networks from 2005 through 2008. A random sampling of the facilities’ annual reports was verified through auditing by subsidiaries from the MoH.
“Many of the target objectives have been achieved,” said Dr. May-Michelangeli. “Most healthcare facilities (89 percent) have reached the best performance class for the global indicator of HAI control based on facility type, resources and activities.”
The findings are extracted from mandatory reporting records to the MoH. Every healthcare facility registered at the MoH has to provide an annual report on infection prevention programs. From these reports, researchers analyzed data from 2,800 facilities including large university hospitals, ambulatory care, long-term care or small community clinics.
“The national mandatory public reporting system has helped healthcare facilities to improve their infection control measures,” said Dr. Brun-Buisson. “Not only do these facilities have funding tied to their compliance with the program, but the media in France now publish a list of best and worst performing hospitals based on each facility’s annual report.”
The French National Program also looked to promote other priority initiatives to reduce HAIs, including advancing new research in the field, improving communication with patients on the risk of infectious diseases, standardizing monitoring methods for HAIs and adopting preventive practices for healthcare professionals.
Key achievements of the program include:
- MRSA cases have decreased by 40 percent;
- Local and regional infection control teams have been appointed in 94 percent healthcare facilities;
- The use of alcohol-based products for hand hygiene doubled in over 50 percent of the sites;
- Nearly all (90 percent) of the facilities have implemented an evaluation program and a system for quickly disseminating infection alerts (96 percent);
- Most facilities (89 percent) have an anti-infective drug committee and have produced guidelines for preventing surgical site infections (97 percent);
- Many facilities (88 percent) follow-up with patients’ antibiotic consumption; and
- Nearly all facilities (98 percent) provide patients an information leaflet on HAIs.
While France’s healthcare system is different from the U.S., researchers believe that reducing HAIs through public reporting can be successfully applied to any healthcare system. To further the goal of improving country-wide control of HAIs, MoH has initiated a second phase of the program that will continue through 2013. This phase includes revised national infection prevention and control objectives and goals for individual healthcare facilities.
BRITAIN FOCUSES ON REPORTING
HOSPITAL INFECTION RATES TO GO ONLINE WEEKLY
People will be able to check the weekly MRSA and Clostridium difficile (C diff) rates at their local hospital, the Government has announced.
From early next month, infection figures for all hospitals in England will be published every seven days on the data.gov.uk website.
Patients will be able to look at data for the previous three months and, over time, infection rates for bugs like E. coli will be added.
Weekly data from March to May for many hospitals is already up and running.
MRSA and C diff infections are now at their lowest level since records began.
Health Secretary Andrew Lansley said: “This is an important step towards our broader plans to provide more relevant information to patients.
“It will enable people to make meaningful choices because they will be able to make comparisons between different hospitals and healthcare organisations.
“We want to make the large amounts of data that are already collected and used internally in the NHS work for patients, not just managers.
“All information that is useful and relevant to patients should be published in an accessible and open way.”
The Government has said it will also look at whether figures should be provided at a department or ward level without breaching confidentiality of patients.
NHS patients will be able to check superbug infection rates at individual hospitals each week under plans to introduce greater transparency to the health service.
From next month, rates of MRSA and Clostridium difficile, which are linked to more than 8,000 deaths a year at hospitals, will be published online in an accessible format.
At present, rates are published only monthly, and are limited to statistics for NHS trusts, which can cover a number of different hospitals.
They are not easy to find using an ordinary internet search engine, meaning that patients struggle to find transmission rates in their local hospital, and so cannot avoid the poor performers.
Andrew Lansley, the Health Secretary, will announce that statistics which are usually available to NHS professionals will be shared with the public as part of a drive to improve transparency and give patients more choice. In time, it is hoped to be able to publish rates for individual hospital departments or even wards.
Other hospital-acquired infections, such as E-coli and MSSA, will also be included in time.
Mr Lansley said: “This is an important step towards our broader plans to provide more relevant information to patients. It will enable people to make meaningful choices because they will be able to make comparisons between different hospitals and health care organisations. We want to make the large amounts of data that are already collected and used internally in the NHS, work for patients, not just managers.
All information that is useful and relevant to patients should be published.
“So instead of publishing health care acquired infections on a monthly basis, we will publish them weekly. We will eliminate the long time lag between data collection and publication, reducing it to a week.
“And instead of data being published at a hospital trust level, which may include the figures for as many as three different hospital sites, we will disaggregate the data to individual hospitals and, confidentiality issues permitting, to ward or department level.
The NHS Choices website, says the worst trusts for infections during 2008/09 included Trafford Healthcare Trust, which covers Trafford General, Altrincham General and Stretford Memorial Hospitals, where there were 3.98 incidences of MRSA per 10,000 “hospital bed days”.
Sherwood Forest Hospitals NHS Trust, which includes King’s Mill, and Newark hospitals, had 3.22 cases.
Lee Ann Torrans
ltorrans@gmail.com
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