Assessment of Perception and Use of First Hospital-Specific Healthcare-Associated Infection Feedback Reports, Georgia

Monday, June 5, 2017: 2:30 PM
400C, Boise Centre
Elizabeth Nicole Smith , Georgia Department of Public Health, Atlanta, GA

BACKGROUND:  Healthcare-associated infections (HAI) cause an estimated 722,000 infections and 75,000 deaths annually, and are often preventable. Regular monitoring and use of HAI data by hospitals is needed to target infection prevention resources. The Georgia Department of Public Health created 125 hospital-specific HAI feedback reports to provide a summary of 2014 data reported by the facility to CDC’s National Healthcare Safety Network (NHSN) with state and national benchmarks for comparison. We assessed how facilities perceived and used the reports.

METHODS:  In October 2015, we sent the HAI summary reports to the CEO and NHSN administrator of hospitals participating in the Centers for Medicaid and Medicare Services Quality Reporting Requirement. Reports provided the hospital’s standardized infection ratio (SIR), SIR interpretation, Georgia’s SIR, number of infections, Health and Human Services HAI reduction goal, number of infections to prevent to reach the goal, status as a top five contributor to Georgia’s SIR, and estimated cost per infection. We invited recipients to take a voluntary online survey March 2016 which asked about the report’s receipt, accuracy, usefulness, frequency, suggested format changes, and desired training.

RESULTS:  There were 41 survey respondents, representing 33% of Georgia hospitals that received reports. Most (81%) indicated receipt by the NHSN administrator and 32% indicated additional staff should receive the report. Twenty-nine percent (29%) of respondents did not know if the report was accurate; 5% said it was inaccurate. Most (83%) found the report useful, specifically the estimated cost per infection (69%), Georgia’s SIR (69%), and single table format (59%). The most common uses of the report were to present HAI data to facility leadership (58%), assess progress toward goals (42%), and prioritize infection prevention activities (42%). One respondent justified hiring additional staff. Suggested report additions were the previous year’s data (68%), number of predicted infections (51%), and 95% confidence interval for the SIR (38%). Over half (60%) wanted training, mostly (79%) in the form of reference documents.

CONCLUSIONS:  The HAI summary reports were a useful tool for sharing data, self-assessment, and prioritization within hospitals. The most important report features were the estimated cost per infection and state comparison data. In response to suggestions, the 2015 feedback report included the number of predicted infections and 95% confidence interval for the SIR. That 29% of respondents did not know if the report was accurate reflects underutilization of data and highlights the continued role for state-conducted data analysis and hospital-specific reporting.