Increased regulatory focus and changes in payment structures have made infection prevention a high-profile objective in hospitals today—and necessitates a new look at the infrastructure that supports the infection prevention department.
Hospitals that previously considered infection prevention primarily a reporting function may have been satisfied with paper-driven systems and with infection preventionists (IPs) spending the majority of their time collating data, manually cross-checking lab results and reporting data retrospectively to the Infection Control Committee and NHSN. But too much is at stake for hospitals to count on slow, manual efforts to achieve the reductions in healthcare-associated infections (HAIs) that they want and need for patient safety sake.
A growing number of hospitals recognize that they need electronic surveillance to identify potential infections and at-risk patients in real time so that they can quickly implement appropriate interventions/precautions, provide quality care, and minimize the spread of communicable diseases, while controlling costs.
- Inspectors for the Centers for Medicare and Medicaid Services (CMS) now have a 49-page survey to use in evaluating hospital infection prevention programs in scheduled or unannounced inspections.1 To avoid citation, hospitals should have a designated, trained infection preventionist, top-level administrative support, ongoing staff education, and “infection control policies and procedures that are based on nationally recognized evidence-based guidelines and applicable state and federal laws.”
- Hospitals in all 50 states must now report central line-associated bloodstream infections (CLABSI) and catheter-associated urinary tract infections (CAUTI) in adult and pediatric medical, surgical and medical/surgical wards as well as intensive care units to NHSN.
- For fiscal year 2015, up to 5% of a hospital’s Medicare reimbursement could be at risk for failure to reduce HAIs and readmissions, with 1% specifically tied specifically to CAUTI and CLABSI rates. The Department of Health and Human Services plans to link 85% of all Medicare payments to quality or value measures by 2016 and 90% by 2018 and is encouraging private payers to follow suit.
- CMS plans to make the adoption of antimicrobial stewardship programs a condition of participation by 2017.2
- The National Action Plan for Combating Antibiotic-Resistant Bacteria released in March calls for hospitals and other healthcare organizations to take steps to prevent the spread of resistant organisms immediately and for all hospitals to report antibiotic use and antibiotic resistance data to NHSN (AUR Module)by 2020.3
With the potential for citations, exclusion from payer programs, fines and reimbursement penalties as well as emerging national requirements for high-performing infection prevention programs, hospitals have more reasons than ever to adopt electronic-assisted surveillance systems that can:
1) transform the clinician’s workflow to be more productive and more sensitive in identifying new intervention opportunities; 2) support efficient and timely electronic reporting of aggregate data to NHSN; 3) augment internal quality improvement efforts at the point of care with increased levels of accountability.
1. Centers for Medicare & Medicaid Services. Hospital Infection Control Worksheet.
2. McKinney M. Hospitals focus on antibiotic overuse as CMS prepares new mandate. December 20, 2014.
3. The White House. National Action Plan for Combating Antibiotic-Resistant Bacteria. March 2015.