The 2008 decision by the Centers for Medicare & Medicaid Services (CMS) to cease additional reimbursement to hospitals forcertain healthcare-associated infections (HAIs) has led to enhancedfocus on infection prevention and changes in practice by front-linestaff, according to a national survey of infection preventionistspublished in the May issue of the American Journal of Infection Control, the official publication of the Association for Professionals inInfection Control and Epidemiology (APIC). A team of researchers and public health policymakers led by GraceM. Lee, MD, MPH, from Harvard Pilgrim Health Care Institute andHarvard Medical School, surveyed head infection preventionists(IPs) at 317 acute care hospitals that were directly impacted bythe policy change, which was enacted to motivate hospitals toeliminate preventable infections. According to the survey results,81 percent of IPs reported increased focus on those HAIs targetedby the policy, namely catheter-associated urinary tract infections (CAUTIs) and central line-associated bloodstream infections(CLABSIs). |
A majority of IPs reported an increase in surveillance, education,and prevention efforts for HAIs targeted by the CMS policy,particularly for CAUTIs. IPs felt that front-line staff removedurinary (71 percent) and central venous catheters (50 percent) morequickly than before, and increased use of antiseptic-containingdressings for central venous catheters (56 percent) for CLABSIprevention. Although the policy did not appear to have a major impact onfunding to support infection prevention departments (77 percent), acloser working relationship between infection prevention andquality improvement departments (57 percent) and greatercollaboration by interdisciplinary teams to prevent HAIs (65percent) was noted in response to the CMS policy. While most of the findings were positive, the survey did identifysome unintended consequences of the policy.
One-third ofrespondents said their hospitals needed to shift resources awayfrom non-targeted infections in order to focus on targetedinfections. IPs also expressed concern that hospitals focusedgreater effort on improving physician documentation and codingpractices to avoid negative financial penalties, rather thanenhancing infection prevention efforts to improve patient outcomes.Finally, a quarter of respondents reported that their hospitalsperformed unnecessary diagnostic testing upon admission to avoidpotential financial penalties. "The CMS policy of eliminating additional payment for certain HAIsappears to have had a positive impact on hospital infectionprevention efforts, yet careful consideration of the potential forunintended consequences is warranted," say the study authors. "AsCMS expands the list of complications for which it will adjustpayment and continues to modify its requirements for reporting, itis critical to ensure that policy changes lead to measureableimprovements in patient outcomes while minimizing potentialunintended consequences." This study is one of the first to assess perceived impact of theCMS payment policy on hospital infection prevention efforts asreported by infection preventionists.
Infection preventionists werechosen for the study because of their organizational knowledge ofinfection prevention surveillance, practices, and documentation. Additional References Citations.
We are high quality suppliers, our products such as China Pellet Cooler , Auxiliary Equipment Manufacturer for oversee buyer. To know more, please visits Pellet Mill Machine.
Related Articles -
China Pellet Cooler, Auxiliary Equipment Manufacturer,