Pub Date : 2012-07-27DOI: 10.1108/14777271211251336
D. Birnbaum, W. Jarvis, P. Pronovost, R. Zarate
Purpose – This paper aims to determine whether the rank order of hospitals changes when their central line‐associated bloodstream infection (CLABSI) rate is computed using a traditional proxy measure for the denominator (number of patients with one or more catheter in place) versus using the actual number of catheters or catheter‐lumens.Design/methodology/approach – The authors conducted a statewide voluntary one‐day prevalence survey among all hospitals participating in Washington State's mandatory public reporting program. Hospitals counted the number of catheters and catheter‐lumens as well as patients with catheters. Counts of patients with one or more catheter in place, of catheters, and of catheter‐lumens were extracted from each hospital's completed survey form and transformed into a ratio. Three CLABSI incidence density rates were computed for each hospital by scaling their annual CLABSI rate in the previous calendar year by the ratio of patients to catheters to catheter‐lumens. Influence of these...
{"title":"Statewide one‐day survey of central lines","authors":"D. Birnbaum, W. Jarvis, P. Pronovost, R. Zarate","doi":"10.1108/14777271211251336","DOIUrl":"https://doi.org/10.1108/14777271211251336","url":null,"abstract":"Purpose – This paper aims to determine whether the rank order of hospitals changes when their central line‐associated bloodstream infection (CLABSI) rate is computed using a traditional proxy measure for the denominator (number of patients with one or more catheter in place) versus using the actual number of catheters or catheter‐lumens.Design/methodology/approach – The authors conducted a statewide voluntary one‐day prevalence survey among all hospitals participating in Washington State's mandatory public reporting program. Hospitals counted the number of catheters and catheter‐lumens as well as patients with catheters. Counts of patients with one or more catheter in place, of catheters, and of catheter‐lumens were extracted from each hospital's completed survey form and transformed into a ratio. Three CLABSI incidence density rates were computed for each hospital by scaling their annual CLABSI rate in the previous calendar year by the ratio of patients to catheters to catheter‐lumens. Influence of these...","PeriodicalId":310544,"journal":{"name":"Clinical Governance: An International Journal","volume":"77 3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129794491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-04-20DOI: 10.1108/14777271211220826
D. Birnbaum
Purpose – From a perspective inside one of the most advanced of the state programs, this presentation aims to explore issues of whom are we trying to reach; what information are we trying to convey; when did this reporting start; where can anyone find reports; why are we doing this; and how does it work. This is, however, neither a typical consumer informatics problem nor a subject that public health is used to dealing with.Design/ methodology/ approach – The paper is a narrative review of personal experience.Findings – Despite achievements, there are fundamental knowledge gaps and unsubstantiated assumptions underlying mandatory public reporting. Research and better role delineation are urgently needed to optimize current choices and ultimately determine whether this is the most cost‐effective strategy among alternative prevention investments.Practical implications – Public health departments are in uncharted territory with this new area of activity, faced with fundamental knowledge gaps that potentially...
{"title":"The US experience with mandatory public reporting","authors":"D. Birnbaum","doi":"10.1108/14777271211220826","DOIUrl":"https://doi.org/10.1108/14777271211220826","url":null,"abstract":"Purpose – From a perspective inside one of the most advanced of the state programs, this presentation aims to explore issues of whom are we trying to reach; what information are we trying to convey; when did this reporting start; where can anyone find reports; why are we doing this; and how does it work. This is, however, neither a typical consumer informatics problem nor a subject that public health is used to dealing with.Design/ methodology/ approach – The paper is a narrative review of personal experience.Findings – Despite achievements, there are fundamental knowledge gaps and unsubstantiated assumptions underlying mandatory public reporting. Research and better role delineation are urgently needed to optimize current choices and ultimately determine whether this is the most cost‐effective strategy among alternative prevention investments.Practical implications – Public health departments are in uncharted territory with this new area of activity, faced with fundamental knowledge gaps that potentially...","PeriodicalId":310544,"journal":{"name":"Clinical Governance: An International Journal","volume":"71 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126916497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-04-20DOI: 10.1108/14777271211220808
Anthony Tellez‐Marfin
Purpose – From the symposium keynote address, this paper aims to explore how healthcare‐associated infections (HAIs) have been transformed from being only a hospital concern to a much broader public health concern.Design/ methodology/ approach – The paper is a narrative review.Findings – HAIs have the characteristics that define issues as public health problems. As a result, public health departments can become important partners in the evolving hospital infection control field. However, whether all state health departments can afford to add HAI experts and whether current public health department HAI activities will be effective in preventing HAIs remain important questions.Practical implications – Public health agencies must be selective about focusing limited resources into areas where they can protect and improve the public's health; whether HAIs are such an area remains to be seen. Although HAIs have historically been the focus of hospitals and hospital‐based services, public health involvement has b...
{"title":"Public health implications of healthcare‐associated infections","authors":"Anthony Tellez‐Marfin","doi":"10.1108/14777271211220808","DOIUrl":"https://doi.org/10.1108/14777271211220808","url":null,"abstract":"Purpose – From the symposium keynote address, this paper aims to explore how healthcare‐associated infections (HAIs) have been transformed from being only a hospital concern to a much broader public health concern.Design/ methodology/ approach – The paper is a narrative review.Findings – HAIs have the characteristics that define issues as public health problems. As a result, public health departments can become important partners in the evolving hospital infection control field. However, whether all state health departments can afford to add HAI experts and whether current public health department HAI activities will be effective in preventing HAIs remain important questions.Practical implications – Public health agencies must be selective about focusing limited resources into areas where they can protect and improve the public's health; whether HAIs are such an area remains to be seen. Although HAIs have historically been the focus of hospitals and hospital‐based services, public health involvement has b...","PeriodicalId":310544,"journal":{"name":"Clinical Governance: An International Journal","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122009355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-04-20DOI: 10.1108/14777271211220871
S. Sheps, D. Birnbaum
Purpose – This editorial aims to summarize major points from and explains the rationale of a symposium convened in Canada to explore whether American experience with mandatory public reporting of healthcare associated infection (HAI) information can usefully inform Canadian policy.Design/methodology/approach – The symposium brought together members of the Universities Council, an interdisciplinary consortium of Canadian and American researchers organized by the Healthcare Associated Infections Program of the Washington State Health Department. Its members are interested in patient safety generally, and a comprehensive strategy to evaluate HAI public reporting specifically.Findings – American health department experts shared insights from their experience with mandatory reporting; Canadian experts, primarily from the British Columbia Centre for Disease Control, described the current reporting policies of Canadian public health authorities. Presentations were discussed by an audience that included members o...
{"title":"Mandatory reporting of healthcare associated infections: Can US experience inform Canadian policy?","authors":"S. Sheps, D. Birnbaum","doi":"10.1108/14777271211220871","DOIUrl":"https://doi.org/10.1108/14777271211220871","url":null,"abstract":"Purpose – This editorial aims to summarize major points from and explains the rationale of a symposium convened in Canada to explore whether American experience with mandatory public reporting of healthcare associated infection (HAI) information can usefully inform Canadian policy.Design/methodology/approach – The symposium brought together members of the Universities Council, an interdisciplinary consortium of Canadian and American researchers organized by the Healthcare Associated Infections Program of the Washington State Health Department. Its members are interested in patient safety generally, and a comprehensive strategy to evaluate HAI public reporting specifically.Findings – American health department experts shared insights from their experience with mandatory reporting; Canadian experts, primarily from the British Columbia Centre for Disease Control, described the current reporting policies of Canadian public health authorities. Presentations were discussed by an audience that included members o...","PeriodicalId":310544,"journal":{"name":"Clinical Governance: An International Journal","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132040645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-04-20DOI: 10.1108/14777271211220835
Bernard Black
Health-care associated infections (HAIs) kill about 100,000 people annually; many are preventable. In response, 18 states currently require hospitals to publicly report their infection rates and national reporting is planned. Yet there is limited evidence on the effects of public reporting on HAI rates, and none on what elements of a reporting plan affect its impact on HAI rates. I review here what little we know, emphasizing my own case study of Pennsylvania.
{"title":"Public Reporting of HAI Rates: What We (Mostly Don’t) Know","authors":"Bernard Black","doi":"10.1108/14777271211220835","DOIUrl":"https://doi.org/10.1108/14777271211220835","url":null,"abstract":"Health-care associated infections (HAIs) kill about 100,000 people annually; many are preventable. In response, 18 states currently require hospitals to publicly report their infection rates and national reporting is planned. Yet there is limited evidence on the effects of public reporting on HAI rates, and none on what elements of a reporting plan affect its impact on HAI rates. I review here what little we know, emphasizing my own case study of Pennsylvania.","PeriodicalId":310544,"journal":{"name":"Clinical Governance: An International Journal","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133731794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-04-20DOI: 10.1108/14777271211220862
W. Jarvis
Purpose – The purpose of this paper is to briefly review the history of healthcare‐associated infection (HAI) prevention programs in the USA since the early 1970s until today, and provide suggestions how other countries (and Canada specifically) may learn from this experience to accelerate HAI prevention and patient safety improvements in their counties.Design/methodology/approach – The paper is a narrative review of literature and personal experience.Findings – US hospitals have had healthcare‐associated infection (HAI) prevention programs, including surveillance for selected HAIs, since the late 1960s‐early 1970s. Such programs began with active surveillance for HAIs based upon the Centers for Disease Control and Prevention's (CDCs) National Nosocomial Infections Surveillance (NNIS) system. This system included standardized definitions and surveillance protocols. Since the 1980s, the CDC has developed HAI prevention guidelines, with categorized recommendations for HAI prevention. In the early 2000s, the...
{"title":"What can Canada learn from the USA's experience in reducing healthcare‐associated infections?","authors":"W. Jarvis","doi":"10.1108/14777271211220862","DOIUrl":"https://doi.org/10.1108/14777271211220862","url":null,"abstract":"Purpose – The purpose of this paper is to briefly review the history of healthcare‐associated infection (HAI) prevention programs in the USA since the early 1970s until today, and provide suggestions how other countries (and Canada specifically) may learn from this experience to accelerate HAI prevention and patient safety improvements in their counties.Design/methodology/approach – The paper is a narrative review of literature and personal experience.Findings – US hospitals have had healthcare‐associated infection (HAI) prevention programs, including surveillance for selected HAIs, since the late 1960s‐early 1970s. Such programs began with active surveillance for HAIs based upon the Centers for Disease Control and Prevention's (CDCs) National Nosocomial Infections Surveillance (NNIS) system. This system included standardized definitions and surveillance protocols. Since the 1980s, the CDC has developed HAI prevention guidelines, with categorized recommendations for HAI prevention. In the early 2000s, the...","PeriodicalId":310544,"journal":{"name":"Clinical Governance: An International Journal","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126653328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-04-20DOI: 10.1108/14777271211220817
R. Stricof
Purpose – This paper aims to describe experience to date with mandatory public reporting of healthcare‐associated infection rates from a perspective inside one of the first and most advanced of the state programs, to help frame the research agenda of an interdisciplinary university faculty collaborative.Design/ methodology/ approach – The paper is a narrative review of personal experience.Findings – Key factors enabling program achievements include starting with a sufficient pilot phase, including strong provisions for audit and validation, a balance of viewpoints among advisors to the program, adoption of internationally respected data systems, and ability to sponsor improvement projects in reporting hospitals. Identified pitfalls and needs for more progress also must be addressed.Practical implications – Public health departments are in uncharted territory with this new area of activity, faced with fundamental knowledge gaps that potentially hamper chances of success. Perspectives explored in this part ...
{"title":"Mandatory public reporting","authors":"R. Stricof","doi":"10.1108/14777271211220817","DOIUrl":"https://doi.org/10.1108/14777271211220817","url":null,"abstract":"Purpose – This paper aims to describe experience to date with mandatory public reporting of healthcare‐associated infection rates from a perspective inside one of the first and most advanced of the state programs, to help frame the research agenda of an interdisciplinary university faculty collaborative.Design/ methodology/ approach – The paper is a narrative review of personal experience.Findings – Key factors enabling program achievements include starting with a sufficient pilot phase, including strong provisions for audit and validation, a balance of viewpoints among advisors to the program, adoption of internationally respected data systems, and ability to sponsor improvement projects in reporting hospitals. Identified pitfalls and needs for more progress also must be addressed.Practical implications – Public health departments are in uncharted territory with this new area of activity, faced with fundamental knowledge gaps that potentially hamper chances of success. Perspectives explored in this part ...","PeriodicalId":310544,"journal":{"name":"Clinical Governance: An International Journal","volume":"102 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114893191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-04-20DOI: 10.1108/14777271211220853
D. Birnbaum, R. Stricof
Purpose – This paper aims to briefly describe the increasingly complex array of organizations influencing American healthcare‐associated infection (HAI) prevention efforts during the modern era of infection control.Design/methodology/approach – This paper is a narrative review.Findings – The modern era of hospital infection control began in the 1950s, but received relatively little publicity until the dawn of the twenty‐first century. Since then, there has been a wave of unprecedented magnitude in individual state legislation mandates followed by a shift from state to federal agency activity. The resulting programs are in varying stages of development, ability, sustainability, and coordination.Practical implications – Many government and healthcare entities are in uncharted territory with this new area of activity, facing challenges in having to coordinate work with many new and unfamiliar partners. Perspectives explored in this part of the Universities Council Symposium help by mapping out the various st...
{"title":"State and federal legislative interests","authors":"D. Birnbaum, R. Stricof","doi":"10.1108/14777271211220853","DOIUrl":"https://doi.org/10.1108/14777271211220853","url":null,"abstract":"Purpose – This paper aims to briefly describe the increasingly complex array of organizations influencing American healthcare‐associated infection (HAI) prevention efforts during the modern era of infection control.Design/methodology/approach – This paper is a narrative review.Findings – The modern era of hospital infection control began in the 1950s, but received relatively little publicity until the dawn of the twenty‐first century. Since then, there has been a wave of unprecedented magnitude in individual state legislation mandates followed by a shift from state to federal agency activity. The resulting programs are in varying stages of development, ability, sustainability, and coordination.Practical implications – Many government and healthcare entities are in uncharted territory with this new area of activity, facing challenges in having to coordinate work with many new and unfamiliar partners. Perspectives explored in this part of the Universities Council Symposium help by mapping out the various st...","PeriodicalId":310544,"journal":{"name":"Clinical Governance: An International Journal","volume":"99 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123279434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-04-20DOI: 10.1108/14777271211220844
Paulette Reid, E. Borycki
Purpose – This paper seeks to provide a narrative review of some of the factors that influence healthcare consumers' information seeking involving healthcare associated infections (HAI) on the internet.Design/methodology/approach – The paper takes the form of a narrative review arising from the authors' presentation and subsequent discussions that took place during the Universities Council Symposium held in Vancouver, Canada in May 2011.Findings – There are a number of important factors that affect healthcare consumers' desire to seek information online about HAI, including the search engine used, the type of technology used, web site usability, information availability, consumers' learning style, consumers' personality traits, and finally, consumers' situational, emotional, and psychological contexts. These factors may affect healthcare consumers' decision making about where they will obtain healthcare (i.e. in their selection of a clinic, hospital, regional health authority and/or health care system).Re...
{"title":"Factors influencing healthcare consumers' search for healthcare associated infection information on the World Wide Web","authors":"Paulette Reid, E. Borycki","doi":"10.1108/14777271211220844","DOIUrl":"https://doi.org/10.1108/14777271211220844","url":null,"abstract":"Purpose – This paper seeks to provide a narrative review of some of the factors that influence healthcare consumers' information seeking involving healthcare associated infections (HAI) on the internet.Design/methodology/approach – The paper takes the form of a narrative review arising from the authors' presentation and subsequent discussions that took place during the Universities Council Symposium held in Vancouver, Canada in May 2011.Findings – There are a number of important factors that affect healthcare consumers' desire to seek information online about HAI, including the search engine used, the type of technology used, web site usability, information availability, consumers' learning style, consumers' personality traits, and finally, consumers' situational, emotional, and psychological contexts. These factors may affect healthcare consumers' decision making about where they will obtain healthcare (i.e. in their selection of a clinic, hospital, regional health authority and/or health care system).Re...","PeriodicalId":310544,"journal":{"name":"Clinical Governance: An International Journal","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127394707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-01-20DOI: 10.1108/14777271211200738
O. Old, T. Rogers
Purpose – Inguinal hernias are a common problem amongst neonates, and a potential source of significant morbidity through incarceration of the hernia. Expedited surgical repair can prevent incarceration and reduce complications. The department at Bristol Children's Hospital aimed to minimise waiting times for surgery thereby reducing incarceration and complication rates. This paper aims to examine how this was done.Design/methodology/approach – Bristol Children's Hospital provides local and regional (tertiary referral) services. Retrospective audit of waiting times from referral to surgery was performed against the departmental standard of four weeks. Data were collected on frequency of incarceration and any complications. Following service restructure, second cycle audit was performed to assess the impact of change.Findings – First cycle audit (n=74) found median waiting time 20 days, (Mean 28.4 days, Range 0‐138 days). A total of 28 per cent of patients waited longer than the target four weeks from refe...
{"title":"Restructuring services to reduce waiting times and prevent complications","authors":"O. Old, T. Rogers","doi":"10.1108/14777271211200738","DOIUrl":"https://doi.org/10.1108/14777271211200738","url":null,"abstract":"Purpose – Inguinal hernias are a common problem amongst neonates, and a potential source of significant morbidity through incarceration of the hernia. Expedited surgical repair can prevent incarceration and reduce complications. The department at Bristol Children's Hospital aimed to minimise waiting times for surgery thereby reducing incarceration and complication rates. This paper aims to examine how this was done.Design/methodology/approach – Bristol Children's Hospital provides local and regional (tertiary referral) services. Retrospective audit of waiting times from referral to surgery was performed against the departmental standard of four weeks. Data were collected on frequency of incarceration and any complications. Following service restructure, second cycle audit was performed to assess the impact of change.Findings – First cycle audit (n=74) found median waiting time 20 days, (Mean 28.4 days, Range 0‐138 days). A total of 28 per cent of patients waited longer than the target four weeks from refe...","PeriodicalId":310544,"journal":{"name":"Clinical Governance: An International Journal","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131280344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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