Public Reporting of Hospital Acquired Infections (HAIs)
When a patient gets an infection while being treated in a hospital, nursing home, outpatient surgery center or dialysis clinic, it’s considered a healthcare associated infection (HAI). These infections are a major public health problem. 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.
Americans get an estimated 1.7 million healthcare-associated infections in the U.S. annually, according to the Centers for Disease Control and Prevention (CDC). Each year these infections:
- Cause about 99,000 deaths
- Cost from $35.7 to $45 billion in additional healthcare costs annually.
South Carolina’s Hospitals Must Share Certain Infection Data with You
In 2006, state lawmakers passed the Hospital Infections Disclosure Act (HIDA). This law requires hospitals to report certain infection rates to the S.C. Department of Health and Environmental Control (DHEC) and the public.
Twice a year, hospitals are required to report infections that patients developed while being treated in the hospital. Hospitals are not required to report infections that patients had when they were admitted.
- Promote better infection prevention practices in South Carolina
- Give S.C. citizens and public health officials a way to measure the state’s progress in reducing, and perhaps one day eliminating, hospital acquired infections.
How Infections are Spread in Hospitals
- Routine care (hands, equipment)
- Ventilators, catheters, central lines and other medical devices
- Overuse of antibiotics
Infection Prevention in Hospitals: The Target is ZERO
While some HAIs will continue to occur, many are preventable.
In recent years, researchers and healthcare professional groups have developed improved infection prevention guidelines and “best practices.” Healthcare teams that have adopted these standards have been very successful in reducing their HAI rates. Consequently, many other hospitals are now training staff to follow the procedures.
Many national leaders in healthcare infection prevention are encouraging hospitals to work toward ZERO infections. For this to happen, top level hospital leaders must support and commit the resources needed to implement and monitor evidence-based prevention practices, measure progress, and ensure public reporting and transparency.
Research shows that when healthcare facilities are aware of their infection issues and implement concrete strategies to prevent them, rates of certain hospital infections can be decreased by more than 70 percent. In fact, the CDC’s National Healthcare Safety Network (NHSN) infection rate data is already showing a decline in HAI rates thanks to increased prevention efforts and monitoring of infection rates.
Increasingly, state and federal governments are also promoting HAI prevention in healthcare facilities. Like DHEC, some are tracking changes in HAI rates to measure progress toward HAI elimination. DHEC is also working with a public-private partnership of healthcare professionals, state agencies and healthcare associations to promote better infection control.
Infection Rates for Specific Surgeries / Procedures
South Carolina’s HIDA reports give you a way to review and compare hospital infection rates for selected surgeries and procedures. You can search for each individual hospital’s rates or you can view comparison reports for surgical procedures and central line infections by hospital patient care location.
During the most recent reporting period, hospitals were required to report infection rates for the following procedures and hospital locations (units/wards) for Central Line Associated Bloodstream Infections (CLABSIs):
- Hospital Locations
- All Adult Inpatient Critical Care Units
- Adult Critical Care Units
- Inpatient Rehabilitation Units
- Long Term Acute Care Units
- Pediatric Inpatient Units
- Pediatric Critical Care Units
- Hematology/Oncology Units
- Bone Marrow Transplant Units
- Pediatric Hematology/Oncology Units
- Heart bypass surgery with chest incision only
- Heart bypass surgery with a chest incision and a separate donor incision
- Hip replacement surgery (total or partial)
- Knee replacement surgery (total or partial)
- Hysterectomy with abdominal incision
- Colon surgeries (only hospitals with less than 200 beds report this)
- MRSA Bloodstream Infections – Lab Reporting
How Hospitals Submit Infection Data
S.C. hospitals submit details about infections, surgical procedures, central line devices, and patient risk factors – all used to calculate infection rates- to the National Healthcare Safety Network (NHSN), a secure, CDC managed, data reporting system. Hospitals give DHEC the right to collect the data from the NHSN.
Comparing Apples to Apples: Adjusting for Risk
Some patients, like those with weak immune systems, run a higher risk of infection than others. Not surprisingly, hospitals that routinely care for these high-risk patients sometimes report more hospital-acquired infections than hospitals that care primarily for lower-risk patients.
To make it possible for you to compare hospitals fairly, HIDA requires that risk factors be taken into account. When hospitals submit surgical site infection statistics, for instance, they also submit certain facts about the pre-existing health of patients (not identified in the reports). Each patient is assigned to a risk category based on that pre-existing health status, wound class, and length of surgery. Hospital-acquired infection rates for each risk category are tallied separately.
How DHEC Verifies Accuracy
DHEC public health professionals visit hospitals to review their HAI records for accuracy and thoroughness. We also make sure hospitals are following standardized procedures in how they gather and report their infection numbers.
In addition, DHEC and the HIDA Advisory Committee — comprised of consumer advocates, private sector medical professionals and others — continually evaluate HIDA procedures, searching for ways to improve the reporting system.
Numbers Don’t Tell the Whole Story
If you are trying to decide which hospital to use for an upcoming procedure, keep in mind that infection rates are one of several important considerations. Also consider:
- Your physician’s advice on hospitals
- The experience level of each facility and its surgeons
- Any health factors unique to you.
Remember that some hospitals may face unusual circumstances that may have affected their HIDA reports or infection prevention efforts.
You may be able to find more information about a hospital’s infection rates and infection control procedures on its Web site.
Understanding the HIDA Reports
The Definition of Terms list on our HIDA Web site may be useful as you review the reports.
“Shining A Light on Hospital Infections”
Our feature article on hospital-acquired infections offers general background information and personal stories on healthcare-acquired infections.
Also see DHEC’s 2011 HIDA Annual Report to the SC General Assembly (pdf)
U.S. Hospital Compare: This U.S. Department of Health and Human Services web site provides information on patient quality, including prevention and care of surgical site infections.
DHEC Healthcare Associated Infections (HAI) Section
Division of Acute Disease Epidemiology
1751 Calhoun Street
Columbia, SC 29201
- Kate Habicht, MPH, Epidemiologist (firstname.lastname@example.org)
- Stanley Ostrawski, RN, MS, MT (ASCP), Infection Preventionist (email@example.com)