Public Reporting of Hospital Acquired Infections (HAIs)
HIDA Hospital Acquired Infections (HAI) Public Reports
Infections that patients get while receiving medical treatment in hospitals, nursing homes, outpatient surgery centers and dialysis clinics are a major public health problem in the United States. These infections are often called healthcare-associated infections. For the HIDA reports, the focus is on hospital acquired infections (HAI). Patients can get them from routine care, surgery, as a complication from medical devices such as ventilators, catheters, and lines, or as a side effect of the overuse of antibiotics.
The U.S. Centers for Disease Control and Prevention (CDC) estimates that 1.7 million healthcare-associated infections occur in U.S. medical facilities each year. These infections result in as many as 99,000 deaths and nearly $20 billion in additional healthcare costs annually. (The estimates are based on 2002 data.)
South Carolina’s Groundbreaking Hospital Infections Disclosure Act (HIDA)
In 2006, the South Carolina General Assembly passed the Hospital Infections Disclosure Act (HIDA) (pdf). This law requires South Carolina hospitals to provide the S.C. Department of Health and Environmental Control (DHEC) and the public with accurate information about their HAI rates. This information must be submitted twice a year.
This law requires South Carolina hospitals to provide the S.C. Department of Health and Environmental Control (DHEC) and the public with accurate and comparable information about hospital-acquired infection (HAI) rates. Patients are often admitted to hospitals with infections that they acquired in other healthcare settings or in the community. However, the HIDA HAI public reports refer only to those infections that meet standardized definitions for hospital acquired infections.
South Carolina was one of the first states in the nation to pass a law requiring public reporting of hospital acquired infection rates. The reports will help promote infection prevention efforts and allow the public and state health officials to measure the state’s progress in reducing or eliminating HAIs .
How Infections are Reported Under HIDA
The National Healthcare Safety Network (NHSN) is the data reporting system that South Carolina hospitals use to send HAI reports to DHEC. NHSN is a secure, internet-based surveillance (monitoring and reporting) system. It is managed by the CDC’s Division of Healthcare Quality Promotion.
Hospitals submit specific infection and procedural information to the NHSN. The information is needed to calculate infection rates for each procedure. Hospitals must assign rights to DHEC to collect the data from NHSN so that the information can be reported to the public. DHEC selected this reporting system with the advice of the HIDA Advisory Committee. For more information, see the NHSN Web site.
Other HIDA Requirements:
- Hospitals must report HAIs to DHEC every six months and make the reports available to the public. The February HAI public report combines data from the mid-year and end-of-year reports to summarize annual HAI rates.
- DHEC must check the accuracy and completeness of the data. DHEC has a “validation” program which includes hospital visits and review of computer reports and records to make sure hospitals are using standard ways of reporting the data.
- Infection rates must be “risk adjusted”. What this means is that for every reportable procedure, hospitals must enter selected information about the patient’s health prior to the surgery that could put them at higher risk for infection. These risk factors allow each person to be assigned into a risk group; infection rates are then calculated for each risk group. It’s vital that the rates be adjusted for risk factors because some hospitals routinely care for much sicker patients than other hospitals. Risk adjustment allows consumers to compare apples to apples, so to speak.
- Hospitals must also report certain infection control / prevention processes to DHEC. The summary report of the first Infection Prevention Survey can be found in the HIDA HAI Reports.
DHEC must submit the HIDA Annual Report to the S.C. General Assembly.
Numbers Don’t Tell the Whole Story
Remember, no single source of information can be used to fairly judge the overall quality of care in a hospital.
A hospital's experience with HAIs is only one thing to consider when choosing a facility. You should also consider the advice of your physician and the experience of the facility and surgeons.
Any health factors that are unique to you should also be taken into account when selecting a hospital.
Again, when comparing rates between hospitals, keep in mind that some patients have medical conditions that make them more likely to get infections. A patient’s age, underlying diseases, and level of illness all affect their risk for developing infection.
How S.C. Hospitals Responded to HIDA
Implementing HIDA has been a challenge for S.C. hospitals. For many years, hospitals have looked at their own infection rates using different ways and resources. This is the first time they have been required to use standard definitions and the same data information system. The NHSN system requires training and knowledgeable infection control staff. Gathering all the information needed to risk adjust and calculate the rates, requires a lot of time and resources.
Individual hospitals and the South Carolina Hospital Association have cooperated in the efforts to implement HIDA. Hospitals may have different experiences that may have affected their reports and prevention efforts. You may be able to find additional information on some of the individual hospital Web sites.
Data Quality:
This is the first HIDA Hospital Comparison report. DHEC and the HIDA Advisory Committee will continue to evaluate the HIDA program and reporting system to look for opportunities to improve.
See Information for South Carolina Residents to help you understand the HAI public reports:
- Shining A Light on Hospital Infections – Feature Article
- Tips on What You Can Do to Protect Yourself From Getting a Healthcare-Associated Infection
- Definition of Terms
Once you are familiar with the Definitions of Terms, go to the reports.
HIDA Hospital Acquired Infections (HAI) Public Reports:
- Individual Hospital HAI Reports
- Comparison Reports for HAIs by Procedure and Hospital Location
- U.S. Hospital Compare (U.S. Department of Health and Human Services, Hospital Compare)
- Preliminary Report on Methicillin Resistant Staphylococcus aureus (MRSA) Bloodstream Infections
- Hospital Infection Prevention Survey - Summary Report
Contact Us
Hospital Infections Reporting Section, DHEC Division of Acute Disease Epidemiology:
E-mail: HAIPublicInformation@dhec.sc.gov
Phone: (803) 898-0861
Page last updated February 19, 2009