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The California Department of Public Health (CDPH) released the 2016 health care-associated infection (HAI) report this week. Overall, California hospitals perform better than the national baseline on three types of infections — surgical site infections (SSI), central line-associated bloodstream infections (CLABSI) and methicillin-resistant staphylococcus aureus bloodstream infections (MRSA BSI). California hospitals perform worse on Clostridium difficile diarrheal infections(CDI). Data are reported using a standardized infection ratio (SIR), with the national average of 1. The CDPH Licensing and Certification Program considers high HAI rates when prioritizing hospitals for surveys.
CDPH is publishing reports in a more streamlined format and has updated its website to include a web page for HAIs in each hospital that allows users to compare results for two or more hospitals side-by-side. Detailed infection-specific data tables, as published in prior years, are available only via the California Health and Human Services Open Data Portal. CDPH has also provided an interactive map. To assist hospitals in responding to inquiries about the data, CHA has developed the attached talking points.
The lowest statewide HAI incidence is among surgical site infections (SIR 0.91). The highest statewide HAI incidence (1.07) is for C. difficile infection that occurs when a patient is treated with antibiotics and inadvertently ingests the organism. CLABSI incidence is significantly lower than national baselines (0.95). MRSA BSI incidence is lower but not statistically significant (0.95).
This report presents HAI data for calendar year 2016 and shows HAI incidence (as standardized infection ratios or SIRs) for 2015 and 2016. Although CDPH previously published 2015 data, both years are included because the Centers for Disease Control and Prevention used 2015 data reported to the National Healthcare Safety Network by all U.S. hospitals to develop new national HAI standard populations (i.e., baseline SIRs). CDPH will use the new baselines to track California hospital HAI prevention progress from 2015 to 2020. Separate national baselines are now available for long-term acute care hospitals, rehabilitation hospitals and units, and critical access hospitals. Their findings are presented separately from the other 332 general acute care hospitals.
The CDPH HAI Advisory Committee recommended HAI reduction goals of 30 percent for CDI and SSI and 50 percent for CLABSI and MRSA BSI by 2020. Many hospitals are making progress toward that goal: 92 hospitals (28 percent) have significantly low incidence for at least one HAI type; 12 hospitals with high HAI incidence in a previous CDPH annual report (2013-15) have significantly lower HAI incidence in 2016; and four hospitals have already reached 2020 HAI goals for all infection types.
Prevention progress is still needed, as indicated by the 133 hospitals (40 percent) that have significantly high incidence for one or more HAI types, and 38 of those hospitals previously had high incidence in the same HAI during one or more years between 2013 and 2015. The CDPH HAI Program has actively worked with hospitals with high infection rates to help identify areas for improvement. Throughout 2017, the program focused on 55 hospitals with high HAI in three of the past four years (2013-16).
