
Background:
Quality measures are increasingly being recorded by hospitals and the Centers for Medicare and Medicaid Services (CMS). It is unknown whether hospitals that perform well in some measures perform well in other measures. The primary aim of this study was to ascertain whether hospitals that perform well on infection controls (IC) measures also perform well on other general quality measures.
Methods:
The following six IC measures were collected as part of a previous study conducted in 20 acute-care hospitals in 16 states: 1) Hand hygiene compliance; 2) Gown compliance; 3) Glove compliance; 4) Central line-associated bloodstream infection rate; 5) Catheter-associated urinary tract infection (CAUTI) rate and; 6) VRE or MRSA rate. The following six quality measures were obtained from CMS Hospital Compare: 1) Rate of hospital-wide 30-day readmission; 2) Rate of serious complications; 3) Nurse communication; 4) Doctor communication; 5) Overall hospital rating and; 6) Venous thromboembolism prophylaxis. Hospitals were assigned a rank for each variable. Spearmans rank correlation coefficients were calculated for each variable pair.
Results:
Among IC measures, strong correlations were observed between: glove compliance and gown compliance (rs=0.92, p=<0.0001) and; gown compliance and hand hygiene compliance (rs=0.68, p=0.001). Among other quality measures, strong correlations were observed between: overall hospital rating and nurse communication (rs=0.90, p=<0.0001); overall hospital rating and doctor communication (rs=0.70, p=0.0006) and; nurse communication and doctor communication (rs=0.73, p=0.003). When examining IC measures with other quality measures, moderate correlations were observed between: hand hygiene compliance and nurse communication (rs=0.53, p=0.016); hand hygiene compliance and overall hospital rating (rs=0.47, p=0.037); VRE or MRSA rate and rate of readmission (rs=0.53, p=0.016) and; CAUTI rate and serious complications (rs=-0.44, p=0.070).
Conclusion:
Overall, there were only 4 moderate correlations observed between IC measures and other quality measures suggesting that hospitals that perform well on IC measures do not perform well on other quality measures.
Figure 1. Hospital rankings by infection control and other quality measures

L. O'hara,
None
L. Pineles, None
S. Li, None
A. D. Harris, None