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Leapfrog Urges Preservation of Transparency of Infection, Safety Measures

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The Leapfrog Group is calling on the Centers for Medicare and Medicaid Services (CMS) to not withhold or curtail public information on deadly infection rates and rates of accidents and injuries in American hospitals, which are among the leading causes of death in the United States. This year’s CMS proposed rule for the Inpatient Prospective Payment System (IPPS) would remove certain critical measures from the one and only federal program that exists to publicly report safety and quality information by hospital: the Inpatient Quality Reporting Program (IQR). Under the IQR, hospitals are paid by Medicare to report on errors, injuries, and infections, and that information is publicly reported for patients and others.

The following are the infection measures slated for removal from the IQR:

  • Catheter-associated urinary tract infection (CAUTI)
  • Clostridium difficile (C. Diff)
  • Central line-associated bloodstream infection (CLABSI)
  • Methicillin-resistant Staphylococcus aureus (MRSA)
  • Surgical site infection (SSI) – hysterectomy and colon
  • Postoperative sepsis rate

In this same proposed rule, CMS is also proposing to remove an important patient safety composite measure, which includes rates of accidents and injuries common in hospitals, from the IQR. This composite and the specific measures within it need to continue to be available to the public in the IQR:

  1. PSI 03 – Pressure Ulcer Rate
  2. PSI 06 – Iatrogenic Pneumothorax Rate
  3. PSI 08 – In-Hospital Fall with Hip Fracture Rate
  4. PSI 09 – Perioperative Hemorrhage or Hematoma Rate
  5. PSI 10 – Postoperative Acute Kidney Injury Requiring Dialysis Rate
  6. PSI 11 – Postoperative Respiratory Failure Rate
  7. PSI 12 – Perioperative Pulmonary Embolism or Deep Vein Thrombosis Rate
  8. PSI 13 – Postoperative Sepsis Rate
  9. PSI 14 – Postoperative Wound Dehiscence Rate
  10. PSI 15 – Unrecognized Abdominopelvic Accidental Puncture/Laceration Rate

Among the reasons given in the proposed rule for removing infections from the IQR is the amount of time hospitals spend counting them, about 2 million hours.

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