Below is the HillCo client report from the August 29 Healthcare Associated Infections and Preventable Adverse Events Advisory Panel meeting.
PAE Rules Update
- Rules were sent last week up to the executive offices for approval
- Might be approved by January 1 – the first quarter reporting date is June 1, 2015
Sunset Advisory Commission Update
- Currently the Advisory Panel’s existence is in statute
- Sunset is proposing to remove the Panel from statute, and the panel would continue under the TAC
- Gives more flexibility to making changes to membership, etc.
- Panel feels like they need “to demonstrate their value”
- Approved suggestion that the Annual report include a summary of the Panel’s accomplishments over the year
Annual Report Update
- 2015 will have PAE data in it
- Just released 2013 annual report – concern that the community doesn’t know anything about it
- Further discussed trying to get a press release out on it, the Panel really thinks this is really important
- Discussed making the annual report more robust, like Tennessee’s
- Believes that it truly has changed facility behavior
- Discussed simplifying the report further for facility boards and the public
- Ex: simple graphics like green smiley faces and red sad faces
- Based on 2009 data, Texas is significantly lower in the occurrence of SSI and CLABSI HAIs, but follow the national trend that they are higher in CAUTI HAIs
- 30 facilities that are required to report have regularly not done so, so they have been sent to Regulatory
- Do not know what Regulatory’s next steps will be
Update on Vascular Catheter Associated Infections
- Currently, vascular catheter associated infections (VCAI) are CMS Hospital Acquired Condition (HAC) and are therefore, reportable as a PAE for Texas mandatory reporting
- There are different types of VCAI and they can be categorized as follows:
- Bloodstream infections due to CVC (may include CLABSI, depending on physician documentation)
- Local infections due to CVC (includes cellulitis)
- Other/Unspecified infections due to CVC
- Problem: Category 1 items may or may not include the NHSN defined CLABSIs and it will be difficult for facilities to ensure they are not double-reporting these infections (once as a PAE and once as a CLABSI). The training involved in identifying and removing these from PAE reporting will be time-intensive and may be difficult to understand
- Proposal: Because it will be difficult avoid double reporting, DSHS proposes using the NHSN CLABSIs as an approximation of the VCAI for PAE reporting. This is similar to our use of NHSN to report CAUTI HAI as an approximation of the CAUTI HAC
- Advantage- Easy to understand; No risk of duplicate entry: Accepting CLABSI as an approximation of VCAI would eliminate the risk of double reporting a CLABSI as a PAE and as an HAL Training of health care personnel to be able to identify which VCAIs are CLABSIs that have been or will be reported via NHSN will not be required and will make reporting simpler for facilities.
- Disadvantage- Loss of data related to minor events: There would be some data loss by accepting the proposed solution. These losses include:
- Bloodstream infections due to CVC that are documented by physicians in the medical record, but do not meet NHSN definition for CLABSI
- Any local infections due to eve (e.g. cellulitis)
- Other/unspecified infections due to CVC