National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (13)
- Antibiotics (1)
- Antimicrobial Stewardship (1)
- Blood Clots (2)
- Cardiovascular Conditions (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (9)
- Central Line-Associated Bloodstream Infections (CLABSI) (11)
- Children/Adolescents (1)
- Clostridium difficile Infections (8)
- Communication (1)
- Comparative Effectiveness (1)
- Comprehensive Unit-based Safety Program (CUSP) (1)
- Critical Care (2)
- Diagnostic Safety and Quality (1)
- Education: Patient and Caregiver (1)
- Elderly (2)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (3)
- Guidelines (1)
- (-) Healthcare-Associated Infections (HAIs) (68)
- Healthcare Costs (4)
- Health Information Technology (HIT) (2)
- Health Insurance (1)
- Health Literacy (1)
- Heart Disease and Health (1)
- Home Healthcare (1)
- Hospital Discharge (1)
- Hospitalization (3)
- Hospital Readmissions (2)
- (-) Hospitals (68)
- Implementation (1)
- Infectious Diseases (20)
- Injuries and Wounds (8)
- Inpatient Care (3)
- Intensive Care Unit (ICU) (2)
- Medical Devices (2)
- Medicare (7)
- Medication (1)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (6)
- Mortality (1)
- Newborns/Infants (1)
- Nursing (2)
- Outcomes (4)
- Patient-Centered Outcomes Research (1)
- Patient Safety (41)
- Payment (7)
- Pneumonia (1)
- Policy (3)
- Practice Patterns (2)
- Prevention (19)
- Provider (1)
- Provider: Health Personnel (1)
- Provider: Nurse (2)
- Provider Performance (10)
- Public Health (5)
- Public Reporting (1)
- Quality Improvement (5)
- Quality Indicators (QIs) (3)
- Quality Measures (4)
- Quality of Care (11)
- Respiratory Conditions (1)
- Risk (5)
- Sepsis (2)
- Surgery (15)
- Teams (1)
- Urinary Tract Infection (UTI) (8)
- Women (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 68 Research Studies DisplayedThom KA, Rock C, Robinson GL
Direct gloving vs hand hygiene before donning gloves in adherence to hospital infection control practices: a cluster randomized clinical trial.
The purpose of this study was to assess the effectiveness of a direct-gloving policy on adherence to infection prevention control practices in a hospital setting. In this study, hospital units were randomly assigned to either the intervention (hand hygiene not required before putting on gloves) or to usual care (hand hygiene required prior to before putting on nonsterile gloves). The primary study outcome was adherence to the expected practice upon room entry and room exit. Thirteen hospital units participated in the trial, and 3,790 health care personnel (HCP) were observed. The study found that adherence to expected practice was higher in the 6 units with the direct-gloving intervention than in the 7 usual care units even when controlling for baseline hand hygiene rates, unit type, and universal gloving policies. The intervention had no effect on hand hygiene adherence measured at entry to non-contact precautions rooms or at room exit. The intervention was related with increased total bacteria colony counts and increased detection of pathogenic bacteria on gloves in the ED and reduced colony counts in pediatrics units, with no change in either total colony count for adult intensive care unit or presence of pathogenic bacteria for adult intensive care unit.
AHRQ-funded; HS024108.
Citation: Thom KA, Rock C, Robinson GL .
Direct gloving vs hand hygiene before donning gloves in adherence to hospital infection control practices: a cluster randomized clinical trial.
JAMA Netw Open 2023 Oct 2; 6(10):e2336758. doi: 10.1001/jamanetworkopen.2023.36758..
Keywords: Hospitals, Patient Safety, Guidelines, Healthcare-Associated Infections (HAIs)
MacEwan SR, Gaughan AA, Beal EW
Concerns and frustrations about the public reporting of device-related healthcare-associated infections: perspectives of hospital leaders and staff.
The purpose of this study was to explore the specific concerns of hospital leaders and staff regarding the identification and public reporting of healthcare-associated infections (HAIs). Between 2017 and 2019 the researchers conducted interviews with 471 participants including hospitals leaders and hospital staff across 18 United States hospitals. The study found that interviewees discussed concerns about public reporting of HAI data, including a lack of trust in the data and unintended consequences of its public reporting, as well as particular frustrations with the identification and accountability for publicly-reported HAIs.
AHRQ-funded; HS024958.
Citation: MacEwan SR, Gaughan AA, Beal EW .
Concerns and frustrations about the public reporting of device-related healthcare-associated infections: perspectives of hospital leaders and staff.
Am J Infect Control 2023 Jun; 51(6):633-37. doi: 10.1016/j.ajic.2022.08.003..
Keywords: Medical Devices, Healthcare-Associated Infections (HAIs), Hospitals, Provider: Health Personnel
Ye S, Li D, Yu T
The impact of surgical volume on hospital ranking using the standardized infection ratio.
Researchers investigated the effect of surgical volume on the accuracy of identifying poorly performing hospitals. Their research was based on the standardized infection ratio, and they applied their proposed method to data from HCA Healthcare from 2014-2016 on surgical site infections in colon surgery patients. They concluded that minimum surgical volumes and predicted events criteria are required to make hospital evaluation reliable, and that these criteria may vary by overall prevalence and between-hospital variability.
AHRQ-funded; HS027791.
Citation: Ye S, Li D, Yu T .
The impact of surgical volume on hospital ranking using the standardized infection ratio.
Sci Rep 2023 May 10; 13(1):7624. doi: 10.1038/s41598-023-33937-y..
Keywords: Hospitals, Surgery, Healthcare-Associated Infections (HAIs), Provider Performance, Quality of Care
Goto M, Hasegawa S, Balkenende EC
Effectiveness of ultraviolet-c disinfection on hospital-onset gram-negative rod bloodstream infection: a nationwide stepped-wedge time-series analysis.
This study evaluated the effectiveness of enhanced terminal room cleaning with ultraviolet C (UV-C) disinfection in reducing gram-negative rod (GNR) infections. The authors used information regarding UV-C use and the timing of implementation through a survey of all Veterans Health Administration (VHA) hospitals providing inpatient acute care from January 2010 and December 2018. Among 128 Veterans Health Administration hospitals, 120 provided complete survey responses with 40 reporting implementations of UV-C systems. UV-C use was associated with a 19% lower incident of hospital-onset (HO) GNR bloodstream infection (BSI).
AHRQ-funded; HS027472.
Citation: Goto M, Hasegawa S, Balkenende EC .
Effectiveness of ultraviolet-c disinfection on hospital-onset gram-negative rod bloodstream infection: a nationwide stepped-wedge time-series analysis.
Clin Infect Dis 2023 Jan 13; 76(2):291-98. doi: 10.1093/cid/ciac776..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Hospitals, Prevention, Sepsis
Likosky DS, Yang G, Zhang M
Interhospital variability in health care-associated infections and payments after durable ventricular assist device implant among Medicare beneficiaries.
The purpose of this study was to examine differences in durable ventricular assist device implantation infection rates and associated costs across hospitals. The researchers utilized clinical data for 8,688 patients who received primary durable ventricular assist devices from the Society of Thoracic Surgeons Interagency Registry for Mechanically Assisted Circulatory Support (Intermacs) hospitals (n = 120) and merged that data with post-implantation 90-day Medicare claims. The primary outcome included infections within 90 days of implantation and Medicare payments. The study found that 27.8% of patients developed 3982 identified infections. The median adjusted incidence of infections (per 100 patient-months) across hospitals was 14.3 and differed according to hospital. Total Medicare payments from implantation to 90 days were 9.0% more in high versus low infection tercile hospitals. The researchers concluded that health-care-associated infection rates post durable ventricular assist device implantation varied according to hospital and were associated with increased 90-day Medicare expenditures.
AHRQ-funded; HS026003.
Citation: Likosky DS, Yang G, Zhang M .
Interhospital variability in health care-associated infections and payments after durable ventricular assist device implant among Medicare beneficiaries.
J Thorac Cardiovasc Surg 2022 Nov;164(5):1561-68. doi: 10.1016/j.jtcvs.2021.04.074..
Keywords: Healthcare-Associated Infections (HAIs), Medical Devices, Medicare, Heart Disease and Health, Cardiovascular Conditions, Hospitals, Payment, Healthcare Costs
Lee PT, Krecko LK, Savage S
Which hospital-acquired conditions matter the most in trauma? An evidence-based approach for prioritizing trauma program improvement.
The purpose of this study was to quantify and compare the impacts of six different hospital-acquired conditions (HACs) on early clinical outcomes and resource utilization in hospitalized trauma patients. The researchers included 529,856 adult patients from the 2013 to 2016 American College of Surgeons Trauma Quality Improvement Program Participant Use Data Files with 5 days or longer of hospitalization and had an Injury Severity Score of 9 or higher. The study found the incidences of HACs were: pneumonia, 5.2%; urinary tract infection, 3.4%; venous thromboembolism, 3.3%; surgical site infection, 1.3%; pressure ulcer, 1.3%; and central line-associated blood stream infection, 0.2%. The HAC of pneumonia demonstrated the largest association with in-hospital outcomes and resource utilization. The researchers reported that prevention of pneumonia within the study group would have resulted in estimated reductions of: 22.1% for end organ dysfunction, 8.7% for prolonged hospitalization, 7.8% for mortality, 7.1% for prolonged intensive care unit stay, and 6.8% for need for mechanical ventilation. The researchers concluded that pneumonia prevention should be a priority activity in program improvement efforts.
AHRQ-funded; HS025224.
Citation: Lee PT, Krecko LK, Savage S .
Which hospital-acquired conditions matter the most in trauma? An evidence-based approach for prioritizing trauma program improvement.
J Trauma Acute Care Surg 2022 Oct 1;93(4):446-52. doi: 10.1097/ta.0000000000003645..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Pneumonia, Urinary Tract Infection (UTI), Blood Clots
McAlearney AS, MacEwan SR, Gregory ME
Identifying management practices for promoting infection prevention: perspectives on strategic communication.
The purpose of this study was to better understand the topics and communication strategies used by hospital administrative and clinical leaders to facilitate healthcare-associated infection prevention. Between 2017 and 2019 the researchers interviewed 188 administrative and clinical leaders in 18 U.S. Hospitals and interviewed them about management practices used to promote the prevention of HAI, with a focus on strategic communications. The study found that information sharing regarding infection prevention focused on two main topics: facilitators of success and barriers to success. The researchers also reported that storytelling using examples of real events was useful. The study concluded that the findings provide useful information about how the strategic communication of HAI information can contribute to improvement and advance hospitals’ infection prevention plans and efforts.
AHRQ-funded; HS024958.
Citation: McAlearney AS, MacEwan SR, Gregory ME .
Identifying management practices for promoting infection prevention: perspectives on strategic communication.
Am J Infect Control 2022 Jun;50(6):593-97. doi: 10.1016/j.ajic.2021.11.025..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Hospitals, Prevention, Communication
McCleskey SG, Shek L, Grein J
Economic evaluation of quality improvement interventions to prevent catheter-associated urinary tract infections in the hospital setting: a systematic review.
This systematic review looked at economic evaluations of quality improvement (QI) interventions to reduce rates of catheter-associated urinary tract infections (CAUTIs). A literature review was conducted for conference abstracts and studies from January 2000 to October 2020. Dual reviewers assessed study design, effectiveness, costs and study quality for eligibility. The reviewers performed a cost-consequence analysis from the hospital perspective, estimating the incidence rate ratio and increment net cost/savings per hospital over 3 years for each eligible study. Fifteen unique economic evaluations were eligible, and 12 studies were amenable to standardization. QI interventions were associated with a 43% decline in infections and wide ranges of net costs relative to usual care.
AHRQ-funded; HS022644.
Citation: McCleskey SG, Shek L, Grein J .
Economic evaluation of quality improvement interventions to prevent catheter-associated urinary tract infections in the hospital setting: a systematic review.
BMJ Qual Saf 2022 Apr;31(4):308-21. doi: 10.1136/bmjqs-2021-013839..
Keywords: Quality Improvement, Quality of Care, Urinary Tract Infection (UTI), Healthcare-Associated Infections (HAIs), Hospitals, Healthcare Costs
Arntson E, Dimick JB, Nuliyalu U
Changes in hospital-acquired conditions and mortality associated with the hospital-acquired condition reduction program.
This study evaluated changes in Hospital-Acquired Conditions (HACs) and 30-day mortality after the announcement of the Centers for Medicare and Medicare Services’ Hospital-Acquired Condition Reduction Program (HACRP) in August 2013. The authors evaluated models to test for changes in HACs and 30-day mortality before and after the Affordable Care Act (ACA), and after the HACRP. Fee-for-service Medicare claims from 2009 to 2015 were used. The HAC rate declined after the ACA was passed and declined further after the HACRP announcement. However, 30-day mortality rates were unchanged.
AHRQ-funded; HS026244.
Citation: Arntson E, Dimick JB, Nuliyalu U .
Changes in hospital-acquired conditions and mortality associated with the hospital-acquired condition reduction program.
Ann Surg 2021 Oct 1;274(4):e301-e07. doi: 10.1097/sla.0000000000003641..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Mortality, Medicare, Payment, Prevention, Patient Safety
Page B, Klompas M, Chan C
Surveillance for healthcare-associated infections: hospital-onset adult sepsis events versus current reportable conditions.
US hospitals are required by the Centers for Medicare and Medicaid Services to publicly report central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), Clostridioidesdiffficile, methicillin-resistant Staphylococcus aureus bacteremia, and selected surgical site infections for benchmarking and pay-for-performance programs. In this study the investigators retrospectively assessed the overlap between HO-ASEs and reportable HAIs among adults hospitalized between June 2015-June 2018 in 3 hospitals.
AHRQ-funded; HS025008.
Citation: Page B, Klompas M, Chan C .
Surveillance for healthcare-associated infections: hospital-onset adult sepsis events versus current reportable conditions.
Clin Infect Dis 2021 Sep 15;73(6):1013-19. doi: 10.1093/cid/ciab217..
Keywords: Sepsis, Healthcare-Associated Infections (HAIs), Hospitals, Clostridium difficile Infections, Catheter-Associated Urinary Tract Infection (CAUTI), Methicillin-Resistant Staphylococcus aureus (MRSA), Central Line-Associated Bloodstream Infections (CLABSI)
Pakyz AL, Wang H, Ozcan YA
Leapfrog Hospital Safety Score, magnet designation, and healthcare-associated infections in United States hospitals.
The goal of this study was to determine whether Magnet designation and hospitals with better Leapfrog Hospital Safety Scores have fewer healthcare-associated infections (HAIs). Findings showed that “A” hospitals performed better on clostridium difficile infection (CDI) but not methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections, while Magnet designation was associated with fewer than expected MRSA infections but more than expected CDIs. These mixed results show that hospital global assessments of safety and workplace quality differentially and imperfectly predict its level of HAIs.
AHRQ-funded; HS018578.
Citation: Pakyz AL, Wang H, Ozcan YA .
Leapfrog Hospital Safety Score, magnet designation, and healthcare-associated infections in United States hospitals.
J Patient Saf 2021 Sep 1;17(6):445-50. doi: 10.1097/pts.0000000000000378..
Keywords: Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Hospitals, Patient Safety
Cabral SM, Goodman KE, Blanco N
Comorbidity and severity-of-illness risk adjustment for hospital-onset Clostridioides difficile infection using data from the electronic medical record.
This study’s objective was to determine whether electronically available comorbidities and laboratory values on admission are risk factors for hospital-onset Clostridioides difficile infection (HO-CDI) across multiple institutions and whether they could be used to improve risk adjustment. Adult patients admitted to 3 hospitals in Maryland from 2016 to 2018 were included. Patients with comorbid conditions were assigned using the Elixhauser comorbidity index. Standardized infection rates (SIRs) were computed using current CDC risk adjustment methodology and included the addition of Elixhauser score and individual comorbidities. Hospital 1 had 314 (0.65%) of patients with a HO-CDI, Hospital 2 had 41 (0.47%) with a HO-CDI, and Hospital 3 had 75 (0.26%) with a HO-CDI. Elixhauser score in multivariable regression was a significant risk factor for HO-CDI at all hospitals when controlling for age, antibiotic user, and antacid use. Abnormal leukocyte level at hospital admission was a significant risk factor at hospitals 1 and 2. Including the Elixhauser score in the risk adjustment model was statistically significant.
AHRQ-funded; HS022291.
Citation: Cabral SM, Goodman KE, Blanco N .
Comorbidity and severity-of-illness risk adjustment for hospital-onset Clostridioides difficile infection using data from the electronic medical record.
Infect Control Hosp Epidemiol 2021 Aug;42(8):955-61. doi: 10.1017/ice.2020.1344..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Hospitals, Risk
Lee BY, Bartsch SM, Lin MY
How long-term acute care hospitals can play an important role in controlling carbapenem-resistant Enterobacteriaceae in a region: a simulation modeling study.
Researchers investigated how implementing control measures in long-term acute care hospitals (LTACHs) can impact carbapenem-resistant Enterobacteriaceae (CRE) spread regionwide. They used their own Chicago metropolitan region agent-based model to simulate CRE spread and control. They found that a prevention bundle in only LTACHs decreased prevalence and averted new carriers, infections, and deaths over 3 years compared with no CRE control measures. When LTACHs and intensive care units intervened, prevalence decreased further. They concluded that LTACHs may be more important than other acute care settings for controlling CRE, and regional efforts to control drug-resistant organisms should start with LTACHs as a centerpiece.
AHRQ-funded; HS023317.
Citation: Lee BY, Bartsch SM, Lin MY .
How long-term acute care hospitals can play an important role in controlling carbapenem-resistant Enterobacteriaceae in a region: a simulation modeling study.
Am J Epidemiol 2021 Feb 1;190(3):448-58. doi: 10.1093/aje/kwaa247..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Prevention, Hospitals, Patient Safety, Implementation
Vsevolozhskaya OA, Manz KC, Zephyr PM
Measurement matters: changing penalty calculations under the Hospital Acquired Condition Reduction Program (HACRP) cost hospitals millions.
Since October 2014, the Centers for Medicare and Medicaid Services has penalized 25% of U.S. hospitals with the highest rates of hospital-acquired conditions under the Hospital Acquired Conditions Reduction Program (HACRP). While early evaluations of the HACRP program reported cumulative reductions in hospital-acquired conditions, more recent studies have not found a clear association between receipt of the HACRP penalty and hospital quality of care. In this article, the authors posit that some of this disconnect may be driven by frequent scoring updates.
AHRQ-funded; HS025148.
Citation: Vsevolozhskaya OA, Manz KC, Zephyr PM .
Measurement matters: changing penalty calculations under the Hospital Acquired Condition Reduction Program (HACRP) cost hospitals millions.
BMC Health Serv Res 2021 Feb 10;21(1):131. doi: 10.1186/s12913-021-06108-w..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Hospitals, Policy, Quality Improvement, Quality of Care, Patient Safety
Reeder B, Makic MBF, Morrow C
AHRQ Author: Rodrick D
Design and evaluation of low-fidelity visual display prototypes for multiple hospital-acquired conditions.
Hospital-acquired conditions such as catheter-associated urinary tract infection, stage 3 or 4 hospital-acquired pressure injury, and falls with injury are common, costly, and largely preventable. This study used participatory design methods to design and evaluate low-fidelity prototypes of clinical dashboards to inform high-fidelity prototype designs to visualize integrated risks based on patient profiles.
AHRQ-authored; AHRQ-funded; 233201500025I; 23337003T.
Citation: Reeder B, Makic MBF, Morrow C .
Design and evaluation of low-fidelity visual display prototypes for multiple hospital-acquired conditions.
Comput Inform Nurs 2020 Nov;38(11):562-71. doi: 10.1097/cin.0000000000000668..
Keywords: Healthcare-Associated Infections (HAIs), Adverse Events, Risk, Hospitals, Prevention
Sankaran R, Gulseren B, Nuliyalu U R, Gulseren B, Nuliyalu U
A comparison of estimated cost savings from potential reductions in hospital-acquired conditions to levied penalties under the CMS Hospital-Acquired Condition Reduction Program.
The Hospital-Acquired Condition Reduction Program (HACRP) from the Centers for Medicare & Medicaid Services (CMS) reduces Medicare payments to hospitals with high rates of hospital-acquired conditions (HACs) by 1% each year. It is not known how the savings accruing to CMS from such penalties compare to savings resulting from a reduction in HACs driven by this program. This study compared the reported savings to CMS from financial penalties levied under the HACRP with savings resulting from potential reductions in HACs.
AHRQ-funded; HS000053; HS026244.
Citation: Sankaran R, Gulseren B, Nuliyalu U R, Gulseren B, Nuliyalu U .
A comparison of estimated cost savings from potential reductions in hospital-acquired conditions to levied penalties under the CMS Hospital-Acquired Condition Reduction Program.
Jt Comm J Qual Patient Saf 2020 Aug;46(8):438-47. doi: 10.1016/j.jcjq.2020.05.002.
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Keywords: Healthcare Costs, Healthcare-Associated Infections (HAIs), Hospitals, Patient Safety, Medicare
Chatterjee P, Williams MD, Coppin JD
Effectiveness of copper-impregnated solid surfaces on lowering microbial bio-burden levels in an acute care hospital.
This study examined whether using novel coper-impregnated solid materials on high-touch surfaces in patient rooms lowered bacterial contamination which may lead to health care-associated infections in acute care hospitals. Sixteen rooms were installed with copper-impregnated surfaces and were compared to standard noncopper laminate surfaces in 16 rooms over a 3-day period. Samples were taken 3 times per day. A lower level of microbial contamination was found in copper-impregnated solid surfaces as compared to standard surfaces.
AHRQ-funded; HS025598.
Citation: Chatterjee P, Williams MD, Coppin JD .
Effectiveness of copper-impregnated solid surfaces on lowering microbial bio-burden levels in an acute care hospital.
Open Forum Infect Dis 2020 Aug;7(8). doi: 10.1093/ofid/ofaa238..
Keywords: Patient Safety, Healthcare-Associated Infections (HAIs), Infectious Diseases, Hospitals, Comparative Effectiveness, Prevention, Evidence-Based Practice
Sheetz KH, Ryan A
Accuracy of quality measurement for the hospital acquired conditions reduction program.
Accuracy of quality measurement for the hospital acquired conditions reduction program.
AHRQ-funded; HS026244; HS000053.
Citation: Sheetz KH, Ryan A .
Accuracy of quality measurement for the hospital acquired conditions reduction program.
BMJ Qual Saf 2020 Jul;29(7):605-07. doi: 10.1136/bmjqs-2019-009747..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Quality Measures, Quality Improvement, Quality of Care, Surgery, Infectious Diseases
Hsu HE, Wang R, Broadwell C
Association between federal value-based incentive programs and health care-associated infection rates in safety-net and non-safety-net hospitals.
The authors assessed the association of Hospital-Acquired Condition Reduction Program (HACRP) and Hospital Value-Based Purchasing (HVBP) implementation with changes in rates of targeted health care-associated infections and disparities in rates among safety-net and non-safety-net hospitals. They found that HACRP and HVBP implementation was not associated with any improvements in targeted health care-associated infections among safety-net or non-safety-net hospitals or with changes in disparities in infection rates. They concluded that, given the persistent health care-associated infection rate disparities, these programs appear to function as a disproportionate penalty system for safety-net hospitals that offer no measurable benefits for patients.
AHRQ-funded; HS018414.
Citation: Hsu HE, Wang R, Broadwell C .
Association between federal value-based incentive programs and health care-associated infection rates in safety-net and non-safety-net hospitals.
JAMA Netw Open 2020 Jul;3(7):e209700. doi: 10.1001/jamanetworkopen.2020.9700..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Central Line-Associated Bloodstream Infections (CLABSI), Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI), Medicare, Patient Safety
Ilieş I, Anderson DJ, Salem J
Large-scale empirical optimisation of statistical control charts to detect clinically relevant increases in surgical site infection rates.
Researchers sought to determine which statistical process control chart types and design parameters maximized the detection of clinically relevant surgical site infection (SSI) rate increases while minimizing false alarms. Statistically significant SSI rate increases (signals) at individual hospitals were identified using 50 different statistical process control chart variations; blinded epidemiologists evaluated the clinical significance of 2709 representative signals of potential outbreaks and rated them as requiring action or no action. The researchers concluded that an optimized combination of two moving average charts had the best performance for identifying clinically relevant small but sustained above-network SSI rates and large short-term individual hospital increases.
AHRQ-funded; HS023821.
Citation: Ilieş I, Anderson DJ, Salem J .
Large-scale empirical optimisation of statistical control charts to detect clinically relevant increases in surgical site infection rates.
BMJ Qual Saf 2020 Jun;29(6):472-81. doi: 10.1136/bmjqs-2018-008976..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Infectious Diseases, Hospitals, Patient Safety
Baker AW, Nehls N, Ilies I
Use of optimised dual statistical process control charts for early detection of surgical site infection outbreaks.
This study analyzed the use of optimized dual statistical process control (SPC) charts to predict surgical site infection (SSI) outbreaks. The researchers retrospectively applied an optimized pair of moving average (MA) SPC charts to all 30 SSI outbreaks previously identified and investigated from 2007 to 2015 in the Duke Infection Control Outreach Network (DICON), which is a network of more than 50 community hospitals. The dual MA SPC chart approach detected all 30 outbreaks at a median of 16 months prior to traditional surveillance detection.
AHRQ-funded; HS23821.
Citation: Baker AW, Nehls N, Ilies I .
Use of optimised dual statistical process control charts for early detection of surgical site infection outbreaks.
BMJ Qual Saf 2020 Jun;29(6):517-20. doi: 10.1136/bmjqs-2019-010586..
Keywords: Healthcare-Associated Infections (HAIs), Surgery, Patient Safety, Hospitals, Public Health, Infectious Diseases
Bartsch SM, Wong KF, Stokes-Cawley OJ
Knowing more of the iceberg: how detecting a greater proportion of carbapenem-resistant Enterobacteriaceae carriers influences transmission.
This study examined the impact of detecting a greater proportion of carbapenem-resistant Enterobacteriaceae (CRE) carriers in the hospital inpatient population. The researchers used the Regional Healthcare Ecosystem Analyst-generated agent-based model of adult inpatient healthcare facilities in Orange County, California. They found that only if the detection level is increased to 1 in 5 carriers does it garner large reductions in the number of new CRE carriers. At the present time the detection level is 1 in 9 carriers.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Wong KF, Stokes-Cawley OJ .
Knowing more of the iceberg: how detecting a greater proportion of carbapenem-resistant Enterobacteriaceae carriers influences transmission.
J Infect Dis 2020 May 11;221(11):1782-94. doi: 10.1093/infdis/jiz288..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Hospitals, Patient Safety, Prevention
Meddings J, Greene MT, Ratz D
Multistate programme to reduce catheter-associated infections in intensive care units with elevated infection rates.
AHRQ’s Safety Program for ICUs aimed to reduce central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) in intensive care units with elevated rates. Included hospitals had at least one adult intensive care unit with elevated CLABSI or CAUTI rates. The investigators targeted intensive care units with elevated catheter infection rates but yielded no statistically significant reduction in CLABSI, CAUTI or catheter utilization in the first two of six planned cohorts. Improvements in the interventions based on lessons learned from these initial cohorts are being applied to subsequent cohorts.
AHRQ-funded; 233201500016I.
Citation: Meddings J, Greene MT, Ratz D .
Multistate programme to reduce catheter-associated infections in intensive care units with elevated infection rates.
BMJ Qual Saf 2020 May;29(5):418-29. doi: 10.1136/bmjqs-2019-009330..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Infectious Diseases, Patient Safety, Urinary Tract Infection (UTI), Intensive Care Unit (ICU), Hospitals, Evidence-Based Practice, Patient-Centered Outcomes Research, Inpatient Care, Critical Care
Ilies I, Benneyan JC, Jabur TBC
Impact of molecular testing on reported Clostridoides difficile infection rates.
This study examined the impact of changing from the enzyme immunoassay (EIA) method to nucleic acid amplification tests (NAATs) to detect incidence of Cloistridoides difficile infection (CDI) in hospitals. The authors analyzed retrospective data from 2009-2017 from 47 hospitals in the southeastern United States. During that time period 37 hospitals switched to NAAT, including 24 with good pre- and post-switch data for statistical analysis. The incidence of CDI detection did go up in hospitals that had transitioned from 10.9 to 23.9 per 10,000 patient days, an average increase of 75%.
AHRQ-funded; HS023821.
Citation: Ilies I, Benneyan JC, Jabur TBC .
Impact of molecular testing on reported Clostridoides difficile infection rates.
Infect Control Hosp Epidemiol 2020 Mar;41(3):306-12. doi: 10.1017/ice.2019.327..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Patient Safety, Hospitals
McHaney-Lindstrom M, Hebert C, Miller H
Network analysis of intra-hospital transfers and hospital onset Clostridium difficile infection.
This paper explores how social network analysis (SNA) software can be used to analyze intra-hospital networks of individuals with a healthcare associated infection (HAI) for further analysis in a GIS environment. The SNA analysis compared cases to controls which highlighted significant differences in the overall structure of the networks.
AHRQ-funded; HS024379.
Citation: McHaney-Lindstrom M, Hebert C, Miller H .
Network analysis of intra-hospital transfers and hospital onset Clostridium difficile infection.
Health Info Libr J 2020 Mar;37(1):26-34. doi: 10.1111/hir.12274..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Infectious Diseases, Hospitals, Public Health