Measuring and Monitoring HAI Reduction Initiatives

John Wisniewski, Healthcare Economic Principal at Xenex, provides a brief history of the domestic policies that led to widespread monitoring of Hospital Acquired Infections (HAIs), and strategies for harnessing accumulated data to design and implement successful HAI rate reduction initiatives. Prior to joining Xenex two years ago, John spent over 26 years in Senior Financial leadership roles in large healthcare systems, giving him great insight into the unique challenges faced by U.S. healthcare facilities.

The Rapid Rise of HAI Monitoring

After President Obama signed the Affordable Care Act into law, CMS was required to develop programs to reward or penalize hospitals based on their performance. Because CMS didn’t already have extensive infrastructure for measuring performance or quality, they began to seek available data reported by hospitals for other purposes.

At the time, hospitals voluntarily reported C. difficile (C. diff), Methicillin-resistant Staphylococcus aureus (MRSA), and certain types of surgical site infections (SSIs) to the CDC through the National Healthcare Safety Network (NHSN). CMS instituted a policy whereby hospitals could either continue to voluntarily report or face a 1% reduction to inpatient Medicare reimbursement. Facilities overwhelmingly decided to cooperate and prevent incurring the penalty.

CMS used the available HAI data to develop a standardized rating called the SIR score (standard infection ratio), adjusting for risk and other factors. SIR includes separate categories for teaching hospitals and facilities with high rates of Community Acquired Infections (CAIs), and also accounts for differences in the methodology hospitals use to test for infections.

Each hospital now has a relatively consistent metric for measuring and entering data. The SIR score influences a hospital’s reimbursement for the Value Based Purchasing (VBP) and Hospital Acquired Condition (HAC) Reduction Programs. What was once a voluntary report built by infection preventionists now has significant ramifications on hospital reimbursement and profitability.

The Impact of Data Reporting on Hospitals

Now that infection rate data has become a primary metric for influencing reimbursement and public perception, hospitals are focused on processes to gather, analyze and impact results.

Progressive hospital operators now invest more resources to analyze the source and trends of infection transmission as part of performance improvement initiatives to reduce HAIs. A new breed of epidemiologically-focused infection preventionists and data analysts are emerging as vital contributors to success.

With HAI metrics becoming critical to quality measurement and improvements, the healthcare industry is challenged to approach data analysis seriously. Accuracy and correct interpretation of data according to CDC’s guidelines can spell success or major losses for hospitals.

Improving Scores

After working with customers around the country, we found that many have current performance improvement initiatives focused on reducing HAIs and improving SIR scores. Our team is taking a more active and consultative role in HAI reduction.

Through this experience, we’re assembling tools, templates and best practices to help guide hospitals in the sophistication of their efforts. Facilities have an exciting opportunity to use new methods to target their risk areas and introduce cutting edge technology for environmental disinfection, such as Xenex Pulsed Xenon UV.

One of the latest trends is to study infection rates at the unit-specific level. Take, for example, a large hospital that treats hundreds of patients every day. We first identify the units of the facility where patients are most at risk of contracting an infection – such as areas where patients have been immunosuppressed or with higher community acquired flow-through. These areas are targeted for a higher dosing of Xenex disinfection to maximize the investment and outcome.

A time gap occurs where hospitals need to adjust to the new focus that CMS placed on infection rates. Facilities around the country are trying to develop infrastructure and organize reporting processes to make a positive impact on the health system. Early results show that these programs are actually making a significant difference.

We are clearly observing nationwide infection rates dropping (although slowly). Our healthcare system has a unique opportunity to emphasize technology and resources combined with analytical information. (View this useful infographic about three innovative technologies that are currently advancing healthcare.)

Hospitals must now make a significant investment of time and effort to study, intervene and monitor HAI reduction initiatives, however, the beauty of this new regulatory environment lies in both the cost savings from avoided infections and the larger opportunity to impact reimbursement based on improved SIR scores. The savings greatly exceed the cost of implementing a successful new program.

To learn more about the Cost/Benefit implications of adding UV disinfection to your HAI reduction program, you can read John’s blog here.

Peer reviewed clinical outcome studies demonstrate the efficacy of Xenex technology. If your facility wants to investigate how Xenex LightStrike™ Robots can contribute to HAI reduction initiatives, request a demo today.

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