TUESDAY, June 22 (HealthDay News) -- Current measures of how
well hospitals control post-operative infections don't reflect
actual results, a new study contends.
The authors of the study in the June 23/30 issue of the
Journal of the American Medical Association propose a new way
of reporting on infection control which, they say, would ultimately
better reflect what's happening in hospitals.
This, in turn, would give patients more useful information with
which to choose the right hospital for them. The data is already
available on a publicly available Web site, the study authors
"We found that what is currently reported is not predictive of outcome," said study lead author Dr. Jonah J. Stulberg, a recent graduate of Case Western Reserve University School of Medicine who is about to begin his residency in the department of surgery. "Data on the Web site doesn't tell you whether you have a decreased level of infection . . . We've come up with a much stronger measure of quality care."
Dr. Clifford Y. Ko is director of the division of research and
optimal patient care at the American College of Surgeons and a
professor of surgery and health services at the UCLA Schools of
Medicine and Public Health. He said: "The bottom line is that the
metrics we're using to measure quality are not exactly as good as
we thought they were. There was little or no correlation between
doing the right thing and having a better outcome."
The American College of Surgeons did a similar study with
similar findings a few years back and is now working with the U.S.
Centers for Disease Control and Prevention to come up with ways to
better measure infection control at hospitals.
The Surgical Care Improvement Project (SCIP) was established in
2006 to cut the rate of complications after surgery. It is based on
20 measures of patient care -- six of them related to prevention of
Hospital-by-hospital data has been made available on a Web site
to help guide patient decisions about which facility to choose when
they need surgical care. Whether hospitals participate in the
program influences their reimbursements from Medicare.
The authors of the new study wanted to know if the "reported
rates of adherence of actually doing these things [the six
infection-control quality measures] were actually associated with a
decreased risk of infection," Stulberg said.
The six measures include whether antibiotics were given an hour
before surgery; whether the appropriate antibiotics were given; and
whether the patients were shaved with a clipper rather than a
razor. Data has overwhelmingly supported clippers for several
decades, because they result in fewer microabrasions to the skin
that could invite infection, Stulberg explained.
The study authors looked at discharge records of nearly 406,000
patients at 398 U.S. hospitals all participating in the SCIP
program. The discharges took place between July 1, 2006 and March
The current recommended procedure for reporting data did not
reflect infection rates as well as the new system developed by the
study authors, the authors said.
The current measure looks at how a hospital is doing overall in
one of the six categories (antibiotic administration, for
instance), while the proposed system looks at how many patients
received all six procedures correctly (the "all-or-none" composite
Although infections are down the past few years, "getting better
is not good enough," Stulberg said. "This is a way for us to push
this program one step further without changing the administration
and reporting [procedures] and all the heavy lifting."
Hospital Compare Web site has information on how