CMS Rule: A Bold Step, But Just One Step Toward Eliminating HAIs – Part 4 of 6

CMS Rule: A Bold Step, But Just One Step Toward Eliminating HAIs – Part 4
August 5th, 2010 9:32 am ET -



Neil Fishman, M.D.
Guest Author - Neil Fishman, M.D.
President of the Society for Healthcare Epidemiology of America (SHEA)
Director of the Department of Healthcare Epidemiology and Infection Control and Director of the Antimicrobial Management Program for the University of Pennsylvania Health System.

With the announcement of the new CMS rule last week, the United States has taken an important first step toward creating a national public reporting system that can be used to guide and monitor our efforts to eliminate healthcare-associated infections (HAIs). To its credit, CMS responded to the recommendations of experts in the field (see SHEA FY 2011 IPPS Comments June 2010) and based the rule upon reporting to the CDC National Healthcare Safety Network (NHSN). This system uses a set of standardized definitions across all acute care settings and data is collected by individuals trained in infection prevention and control. While the rule helps establish a strong base for public transparency, it remains a smaller achievement in comparison to initiatives in other developed countries such as France. Here in the U.S., we must:

Look beyond the ICU. Recognize that CLABSIs do not just occur in the ICU. Indeed, the majority of these infections may occur outside the intensive care setting and should also be reported.

Validate reported data. While reporting based upon standardized definitions is a critical component of an effective system, we must insure that the definitions are interpreted uniformly and that data is recorded honestly.
Improve the definitions. While NHSN is the most accurate system for reporting and analyzing HAI data in the U.S., it uses surveillance definitions that frequently conflict with clinical definitions. This is confusing to front line physicians.
Help patients interpret and synthesize the data. Reported rates will be published on Hospital Compare and we hope this will fuel the effort to eliminate HAIs. Such data will have limited immediate impact on a patient’s choice of healthcare facility, but in the long-term, should be a basis for helping patients and families synthesize key questions that can guide and improve their care.
We welcome CMS as a partner in prevention and congratulate them on implementing this bold new rule. We also look forward to working with CMS and the CDC to refine the system, to create transparent and accurate national public reporting, and to achieve our common goal of eliminating HAIs.

http://blogs.cdc.gov/safehealthcare/?p=685

complete serie:
http://blogs.cdc.gov/safehealthcare/