Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-19T22:47:50.328Z Has data issue: false hasContentIssue false
  • English
  • Français

The impact of measurement changes on evaluating hospital performance: The case of catheter-associated urinary tract infections

Published online by Cambridge University Press:  16 September 2019

Heather E. Hsu Open the ORCID record for Heather E. Hsu [Opens in a new window] ,
Rui Wang ,
Maximilian S. Jentzsch ,
Kelly Horan ,
Robert Jin ,
Donald Goldmann ,
Chanu Rhee  and
Grace M. Lee
Heather E. Hsu*
Affiliation:
Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, Massachusetts
Rui Wang
Affiliation:
Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, Massachusetts Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
Maximilian S. Jentzsch
Affiliation:
Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, Massachusetts Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
Kelly Horan
Affiliation:
Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, Massachusetts
Robert Jin
Affiliation:
Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, Massachusetts
Donald Goldmann
Affiliation:
Institute for Healthcare Improvement, Boston, Massachusetts
Chanu Rhee
Affiliation:
Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, Massachusetts Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
Grace M. Lee
Affiliation:
Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California
*
Author for correspondence: Heather Hsu, MD, MPH, Email: heather.hsu@bmc.org
Get access Rights & Permissions [Opens in a new window]

Abstract

Catheter-associated urinary tract infections in 592 hospitals immediately declined after federal value-based incentive program implementation, but this was fully attributable to a concurrent surveillance case definition revision. Post revision, more hospitals had favorable standardized infection ratios, likely leading to artificial inflation of their performance scores unrelated to changes in patient safety.

Type
Concise Communication
Information
Infection Control & Hospital Epidemiology , Volume 40 , Issue 11 , November 2019 , pp. 1269 - 1271
Copyright
© 2019 by The Society for Healthcare Epidemiology of America. All rights reserved. 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

a

Senior authors of equal contribution.

References

Quality Improvement Group, Office of Clinical Standards & Quality, Centers for Medicare & Medicaid Services. Memorandum: reporting period and reliability of AHRQ, CMS 30-day and HAC quality measures—revised. Centers for Medicare & Medicaid Services website. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/hospital-value-based-purchasing/Downloads/HVBP_Measure_Reliability-.pdf. Published 2011. Accessed February 1, 2019.Google Scholar
HAI surveillance changes for 2015. NHSN e-news. 2014;9(3):4–11.Google Scholar
National Healthcare Safety Network. Paving the path forward: 2015 rebaseline. Centers for Disease Control and Prevention website. https://www.cdc.gov/nhsn/2015rebaseline/index.html. Published 2018. Updated January 23, 2018. Accessed May 30, 2018.Google Scholar
Device-associated module. Urinary tract infection (catheter-associated urinary tract infection [CAUTI] and non–catheter-associated urinary tract infection [UTI]) and other urinary system infection [USI]) events. Centers for Disease Control and Prevention website. https://www.cdc.gov/nhsn/pdfs/pscmanual/7psccauticurrent.pdf. Published 2018. Accessed May 30, 2018.Google Scholar
Hsu, HE, Wang, R, Jentzsch, MS, et al. Association between value-based incentive programs and catheter-associated urinary tract infection rates in the critical care setting. JAMA 2019;321:509–511.CrossRefGoogle ScholarPubMed
The Preventing Avoidable Infectious Complications by Adjusting Payment (PAICAP) Project website. https://www.paicap.org/index.html. Accessed February 1, 2019.Google Scholar
Dicks, KV, Baker, AW, Durkin, MJ, et al. The potential impact of excluding funguria from the surveillance definition of catheter-associated urinary tract infection. Infect Control Hosp Epidemiol 2015;36:467–469.CrossRefGoogle ScholarPubMed
Department of Health and Human Services, Centers for Medicare and Medicaid Services. 42 CFR Parts 405, 412, 413, 414, 416, 486, 488, 489, and 495. Federal Register. 2017;82(155):38259.Google Scholar
Fakih, MG, Groves, C, Bufalino, A, Sturm, LK, Hendrich, AL. Definitional change in NHSN CAUTI was associated with an increase in CLABSI events: evaluation of a large health system. Infect Control Hosp Epidemiol 2017;38:685–689.CrossRefGoogle ScholarPubMed
Huber, K, Cycan, K. The impact of NHSN definition changes on the attribution of secondary bloodstream infections. Open Forum Infect Dis 2016;3 suppl 1.CrossRefGoogle Scholar