1216. Comparison of Internal Scorecard Results Utilizing Individual Infection Ratios (IIR) vs. Standardized Infection Ratios (SIR)
Session: Oral Abstract Session: New Insights into C. difficile Transmission and Reporting
Saturday, October 5, 2013: 9:15 AM
Room: The Moscone Center: 200-212
Background: Our healthcare system utilizes a quality scorecard, tracking hospital-level performance on various quality measures, with pre-specified goals. Infection-related indicators are reported using an SIR with goals set based on data published and utilized by the National Healthcare Safety Network (NHSN).

Prior to NHSN releasing the risk adjustment model for Clostridium difficile infection (CDI) SIR, the system used an IIR to assess each facility’s success in reducing CDI. CDI IIR/SIR goals are set at 1.0 (minimum), 0.75 (threshold), 0.50 (target), and 0.25 (maximum).

Methods: 2011 and 2012 CDI IIR and SIR were calculated. For 2011 IIR, 2010 data were used as baseline and 2011 data were used as baseline for 2012 IIR. For SIR, the NHSN risk adjustment model was applied to the data for 2011 and 2012. Ratios were then compared to each other.

Results: (See Table 1) For 2011, the median percent difference between IIR and SIR for CDI was -9.8% (range -87.3 to 83.1). For 2012, the median percent difference was -12.2% (range -69.9 to 84.6).

Using IIR for 2011, 2 facilities received scorecard credit, however, 6 facilities performed well enough to receive credit using SIR. For 2012, 4 facilities earned credit using IIR, while 7 facilities qualified using SIR.

Table 1: 2011-2012 Comparison of IIR and SIR

Facility

2011 IIR

2011 IIR Scorecard Result

2011 SIR

2011 SIR Scorecard Result

2011 % Difference

2012 IIR

2012 IIR Scorecard Result

2012 SIR

2012 SIR Scorecard Result

2012 % Difference

A

1.18

NC

2.16

NC

83.1

0.47

Target

0.87

Min

84.6

B

1.46

NC

1.29

NC

-11.7

1.05

NC

1.27

NC

20.9

C

1.15

NC

1.17

NC

1.8

0.99

Min

1.14

NC

14.8

D

1.02

NC

1.11

NC

9.5

0.51

Thresh

0.56

Thresh

9.9

E

1.03

NC

0.93

Min

-9.8

1.01

NC

0.88

Min

-12.2

F

1.08

NC

1.16

NC

8.2

1.25

NC

1.23

NC

-1.1

G

0.88

Min

0.67

Thresh

-22.9

1.05

NC

0.70

Thresh

-33.3

H

0.00

Max

0.00

Max

0.0

0.85

Min

0.42

Target

-50.4

I

1.65

NC

0.78

Min

-52.5

1.74

NC

1.22

NC

-29.8

J

2.93

NC

0.53

Thresh

-81.9

1.78

NC

0.92

Min

-48.3

K

2.39

NC

0.30

Target

-87.3

1.40

NC

0.42

Target

-69.9

Total

1.17

 

1.02

 

-13.2

1.01

 

0.99

 

-2.3

Scorecard Result: NC=No credit; Min=Minimum (1.0); Thresh=Threshold (0.75); Target=Target (0.50); Max=Maximum (0.25)

Conclusion: Using IIR allowed for assessment of individual facility progress reducing CDI. Using SIR positively affects scorecard performance and allows for a meaningful comparison of our healthcare system’s data to national trends in CDI. Using the two ratios in tandem allows for overall assessment of CDI prevention performance.

Kathleen Gase, MPH, CIC1, Raya R. Khoury, MPH1, Jake Bishop1, Sandra Mccormick1 and Hilary M. Babcock, MD, MPH2, (1)BJC Healthcare, St. Louis, MO, (2)Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, MO

Disclosures:

K. Gase, None

R. R. Khoury, None

J. Bishop, None

S. Mccormick, None

H. M. Babcock, Sanofi-Aventis: , Speaker honorarium

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