Infection-prevention professionals, hospital officials suggest steps to simplify and streamline HAI tracking system


Infection-prevention leaders and state hospital association representatives participated in regional meetings sponsored across the country during the summer of 2009 by the U.S. Department of Health and Human Services (HHS) and suggested ways that the Centers for Disease Control and Prevention’s (CDC) National Healthcare Safety Network (NHSN)—a leading federal system for tracking healthcare-associated infections (HAIs)—could be made easier for hospitals. Participants recommended steps to reduce data-collection burdens and to increase usefulness for hospital infection prevention and quality-improvement (QI) programs.

HHS convened the regional meetings to get stakeholders’ input into HHS’ Action Plan to Prevent Healthcare-Associated Infections (www.hhs.gov/ophs/initiatives/hai/index.html), as well as to hear about their experiences with the network. The action plan is a blueprint for HAI prevention and sets specific targets for monitoring and preventing HAIs nationally. Leaders from various HHS agencies, including the Agency for Healthcare Research and Quality (AHRQ), CDC, Centers for Medicare and Medicaid Services (CMS), the National Institutes of Health (NIH), and the Office of Public Health and Science joined me in discussing participants’ concerns at these meetings.

HHS uses NHSN data to help monitor progress toward the action plan goals. Twenty-eight states require hospitals to report HAIs publicly; most use the NHSN (www.cdc.gov/nhsn). Hospital enrollment in the NHSN has increased dramatically, to more than 2,700 hospitals in mid-2010 from 300 in 2005.

Daniel Pollock, MD, the surveillance branch chief for CDC’s Division of Healthcare Quality Promotion, and I reported on CDC’s efforts to update the NHSN and improve its ease of use. Simplifying and streamlining the system, and assuring sufficient technical capacity and user support, are top priorities. For example:

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  • CDC has instituted changes in data collection requirements for healthcare-associated urinary tract infections into the NHSN application;
  • More NHSN staff were hired to perform comprehensive assessments and upgrades of the system’s technical infrastructure and usability, and to provide additional user support for enrollment and training;
  • NHSN will begin migrating this fall to a new system of authenticating users; and
  • NHSN Web pages are being redesigned to speed response times during peak use.

Dr. Pollock emphasized that the CDC is committed to accelerating the transition from manual to electronic case detection and reporting for the NHSN, and leveraging advances in health information technology as a primary strategy for enhancing the NHSN. As part of that effort, NHSN now is accepting electronic infection records submitted by hospitals that use commercial infection control surveillance systems.

The CDC continues to work closely with AHRQ, CMS, and the Office of the National Coordinator for Health Information Technology to coordinate integration efforts of federal information systems that provide HAI data. That is part of our commitment here in Washington to support hospitals’ efforts to reduce and eliminate HAIs, and to make healthcare safer for patients and families.

Don Wright, MD, MPH,

deputy assistant secretary for healthcare quality,

U.S. Department of Health and Human Services

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