1. Healthcare-associated Infection Prevention Advisory Board Survey Results July 23, 2013

2. Survey Overview A four (4) question survey was developed using Survey Monkey and sent to the FDOH Healthcare-associated Infection (HAI) Prevention advisory board via email on July 12, 2013. Board members, excluding FDOH and the Agency for Health Care Administration (AHCA) staff, were asked to complete the survey. 8 of 12 (67%) of the board members completed the survey. Surveys were completed between July 12 – 22, 2013. The following statement was included in the email with the survey link. We do have consensus between the boards for AHCA to pull data from the CMS Hospital Compare page for Florida hospitals and include on Health Finder. At a minimum, AHCA will include the HAI data that CMS reports on Hospital Compare on Florida Health Finder in the same format that data is already being reported on Health Finder. This means we will have "one stop shopping."

3. FDOH HAI Advisory Board Consists of 14 members – 2 from AHCA (excluded) – 2 from long-term care (Florida Health Care Association & Florida Association for Directors of Nursing Administration in Long-term Care) – 8 associated with acute care (Florida Hospital Association, Florida Infectious Disease Society, Hospital Corporation of America, Florida Professionals in Infection Control, Hospital Epidemiology, Infection Preventionists) – 1 from Council of State and Territorial Epidemiologists – 1 from FMQAI, Florida’s Quality Improvement Organization

4. RESULTS

5. Question 1

6. Question 2 What would be the advantages of AHCA gaining their own access to NHSN data? 100% (8/8) responded to this open text question. The data will made available to the public consistently Reported data would be more accurate then what they currently get from administrative coding gather data and configure it in a useful way To align public reporting through AHCA with public reporting through NHSN I am not sure of an advantage...more concerned about having too many different rules impacting mandatory reporting. I think AHCA can use the site as is. DUR, SIR and incidence rates. Actual data none More data would be available in a more timely way. CMS analyses can only be performed from hospitals with sufficent data on a quarterly basis. More hospitals will have data that is analyzable over longer periods. The data will be timely, actionable and with more granularity.

7. Question 3

8. Question 4 Please provide any additional comments you would like to share. 62.5% (5/8) responded to this open text question. Responses are below and continue on the next slide. Those of us who served on original task force for implementing the reporting rule recommended using NHSN data. At that time it was starting to get up and running and was felt it would take several years to get it. Well the years have passed and data now there. One requirement would to only require the same data that CMS requires. In other words that is all that some people report to NHSN while others summit additional infection data. It would be a tremendous burden on most to have to submit additional info.

9. Question 4: Open text responses cont’d I would support the same reporting to AHCA that is required for reporting to NHSN by the CMS IPQR program. I would not support additional reporting to AHCA nor would I endorse giving AHCA access to any other data reported to NHSN by healthcare facilities. Without a rule that provides funding to support extra added reporting and response, I believe that using the CMS inpatient quality report is more than adequate for consumers to evaluate care related to HAIs. The NHSN will only give the snapshot of the ICU units. Some hospitals do report the medical units although the the CMS IQR this is not required. The public would need to understand that the ICU rates will vary even among different ICU units i.e. SICU, Neuro and MICU will have different expected number of infections and different pooled means. Data errors and recalls experienced

10. Summary 75% (6/8) think it would be beneficial for AHCA to gain their own access to NHSN data for public reporting purposes and would support a rule change. Support is only for data already being collected for Centers for Medicare and Medicaid Services Inpatient Quality Reporting Program and reported on Hospital Compare. 25% (2/8) think that AHCA using data from Hospital Compare is sufficient and do not see an advantage to AHCA gaining their own access or are concerned with too many rules impacting public reporting.

11. Decision Points Option 1: Implement a rule to form a NHSN Users Group allowing AHCA access to obtain and publicly report HAI data on FloridaHealthFinder.gov  Mandatory reporting for all hospitals?  Should AHCA remove the AHRQ Infection Measures (Postoperative Sepsis and Central Venous Catheter-related Bloodstream Infections)? Option 2: Download HAI data from CMS website (http://data.medicare.gov) and post on FloridaHealthFinder.govhttp://data.medicare.gov  Should AHCA remove the AHRQ Infection Measures (Postoperative Sepsis and Central Venous Catheter-related Bloodstream Infections)? Option 3: Link to CMS Hospital Compare (http://www.medicare.gov/hospitalcompare/search.html)http://www.medicare.gov/hospitalcompare/search.html  Each hospital’s profile page and/or the Hospital/ASC landing page? Option 4: No change

12. Thank You Questions? A.C. Burke, Florida Department of Health Division of Disease Control and Health Protection Bureau of Epidemiology Phone: 850-766-7547 Email: AC_Burke@doh.state.fl.us