The Five "W"s of the Targeted Assessment for Prevention (TAP) Strategy
WHAT is the TAP strategy?
The Targeted Assessment for Prevention (TAP) strategy is a method developed by the Centers for Disease Control and Prevention (CDC) to use data for action to prevent healthcare-associated infections (HAIs). The TAP strategy targets healthcare facilities and specific units within facilities with a disproportionate burden of HAIs so that gaps in infection prevention in the targeted locations can be addressed. The TAP report uses a metric called the cumulative attributable difference (CAD). The CAD is the number of infections that must be prevented to achieve a HAI reduction goal and is calculated by subtracting a numerical prevention target from an observed number of HAIs. The TAP report allows for the ranking of facilities, or locations within individual facilities, by the CAD to prioritize prevention efforts where they will have their greatest impact.
WHO is using the TAP strategy?
CDC is working with partners such as the Centers for Medicare & Medicaid Services (CMS) Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs), State Health Departments, healthcare systems, and facilities to incorporate the TAP strategy into their quality improvement work. Prevention partners engaged in quality improvement and collaborative work may use the TAP strategy to identify and reach out to facilities within their jurisdictions to assist them with prioritizing HAI prevention throughout facilities or within specific locations. In this way, groups and facilities can use data for action to target gaps for prevention and intervention.
WHERE does the data that is used for the TAP strategy come from?
Data used for the TAP strategy are reported by healthcare facilities to CDC’s National Healthcare Safety Network (NHSN). Healthcare facilities may use their own data to generate TAP reports for different HAIs and patient care locations. Other entities (e.g., QIN-QIOs, Health Departments, hospital associations) that have access to NHSN data through NHSN’s "Group" function may also generate TAP reports for the healthcare facilities within their groups/states. Publically available data from NHSN (e.g., CMS Hospital Compare) may also be used to rank facilities according to their CAD.
WHY is CDC using the TAP strategy?
CDC strives to move toward the goal of HAI elimination by using data to target prevention efforts and measure progress. The CDC TAP strategy uses the CAD metric to identify healthcare facilities, or locations within facilities, with a disproportionate burden of HAIs above the Department of Health and Human Services (HHS) prevention targets so that limited prevention resources can be used most effectively. This strategy can be tailored to specific HAI reduction goals and healthcare settings. The CAD is based upon and complimentary to CDC’s main HAI metric, the Standardized Infection Ratio (SIR). The CAD will not replace the SIR; the SIR will remain CDC’s main measure of progress toward the elimination of HAIs. Instead, the CAD will be used in conjunction with the SIR, specifically serving as the metric for the TAP strategy that is intended to accelerate prevention to meet goals on the way toward elimination.
WHEN will the TAP strategy be available?
In January 2015, TAP reports became available within the NHSN application for use by hospitals and NHSN Groups with access to hospital data. These reports are available for catheter-associated urinary tract infections (CAUTI), central line-associated bloodstream infections (CLABSI), and laboratory-identified (LabID) event Clostridium difficile infections (CDI). CDC is also developing tools to evaluate and address the gaps in infection prevention within targeted facilities. CDC plans to expand the TAP strategy to other HAI types as well as other healthcare settings when data are available to generate the reports.