Hospital Leaders Respond to Public Reporting Health Care-Associated Infections Data

Some individuals believe health care-associated infections data should be more transparent than what hospitals provide. How does the hospital leadership react to the publicly-reported data?

While the reason for public-reporting of health care associated infections (HAIs) by health systems is to encourage improvement in infection prevention, the data is not always trusted. How this information is disseminated is concerning for hospital leaders and health care workers.

To address this situation, a study was published recently in the American Journal of Infection Control titled “Concerns and frustrations about the public reporting of device-related health care-associated infections: perspectives of hospital leaders and staff.” Sarah R. MacEwan, PhD, an assistant professor in the Division of General Internal Medicine at The Ohio State University, and the lead author of the study, answered questions for Infection Control Today® (ICT®) about the data she and her colleagues gathered.

ICT®: What are the key findings of this study, and why are they important?

Sarah R. MacEwan, PhD: Our study revealed the concerns and frustrations of hospital leaders and staff regarding the public reporting of HAIs, with a focus on device-related catheter-associated urinary tract infections (CAUTIs) and central line-associated bloodstream infections (CLABSIs). Across hospital sites and interviewee roles, study participants expressed concerns about a lack of trust in publicly-reported HAI data and questions about the consequences of the public reporting of this data. Participants also voiced frustrations about the ways in which infections were identified and reported as HAIs. These frustrations included the way in which culturing practices impacted the identification of HAIs (or lack thereof) and the accountability for HAIs, both in how infections were attributed to devices and how infections in transferred patients were attributed to receiving hospitals.

These findings are important in that they help identify opportunities to improve strategies for identifying and reporting HAIs, as well as consider opportunities to modify the penalty programs for which HAIs are publicly reported. Ultimately, our research provides a reminder that publicly-reported HAI data should be a reliable and trusted resource to inform infection prevention practices. Addressing the concerns revealed in our study can help ensure publicly-reported HAI data are driving meaningful improvements in patient safety by facilitating the prevention of HAIs.

ICT®: What results surprised you, if any?

SM: Many of our findings will not be a surprise to individuals working in the field of infection prevention. However, we were surprised that these themes have not been well documented in the context of research studies. We believe the findings from this study help to demonstrate that these perspectives are held across hospitals and roles, including hospital leaders as well as those on the frontlines of infection prevention, such as health care providers and infection prevention specialists. The more we can shine a light on these concerns, the better informed we can be to improve the ways in which public reporting of HAIs can support infection prevention efforts.

ICT®: What are some of your plans for this work?

SM: This work is part of a larger study to identify and understand management strategies to support infection prevention practices. Efforts by our research team are ongoing to disseminate a toolkit of management strategies that has culminated from this study and validate a survey tool to help health care organizations identify gaps in management practices that can be addressed to improve infection prevention practices.