HICPAC NHSN Michael Howell, MD, MPH Chief Quality Officer University of Chicago Medicine HICPAC NHSN Co-Chair HICPAC July 2017
Agenda (How did we get to now?) details Goal Members from HICPAC Prioritization: If the accomplished the two most important things in the next 12 months, what would they be? Composition: Who else should be part of the?
(How did we get to now?)
NHSN History Dan Pollock, MD (Surveillance Branch Chief) from HICPAC
Details
Goal, Scope, and Reporting To inform National Healthcare Safety Network (NHSN) planning and development on subjects such as: analytics, data elements, definitions and processes. This will provide regular and ad hoc input on NHSN-related issues. Input will be summarized and presented at public HICPAC meetings. from HICPAC
Members (1/3) HICPAC Representatives Hilary Babcock Vickie Brown Michael Howell (co-chair) Lynn Janssen Lisa Maragakis Sheri Chernetsky Tejedor Debbie Yokoe (co-chair) from HICPAC
Members (2/3) External Subject Matter Experts Patti Grant, APIC Anthony Harris, University of Maryland Marion Kainer, CSTE Kathleen Rauch, Healthcare Association of New York State Connie Steed, NHSN User representative Kaede Ota Sullivan, Temple University Tom Talbot, Vanderbilt University School of Medicine Loretta Willis, Hospital Association of New York State from HICPAC
Members (3/3) CDC Technical Consultants Jeneita Bell Kathy Bridson Maggie Dudeck Jonathan Edwards Kent Lemoine Dan Pollock Lauren Wattenmaker from HICPAC
from HICPAC The will provide input on NHSN topics, including: Data access policies and practices Data validation Quality measurement priorities and methods Data use for HAI prevention at the facility, local, state, & national levels Informatics/information technology advances and surveillance improvements, including data security and IT platforms from HICPAC
Brief Report from First Kick-off Call (6/29/2017)
First meeting Met by teleconference on June 29, 2017. Agenda: Background Decision to shift NHSN Steering Committee to a HICPAC Expanded mission of the Current state of NHSN, what s working and challenges CDC perspective member perspective Additional expertise/representation needed on Prioritize areas for initial focus Next steps from HICPAC
Major points of discussion Consensus about NHSN Tremendous impact -- leading to critical improvements in HAI prevention. Trusted platform for HAIs, antimicrobial resistance, and antibiotic use. Strong collaborative relationships with important partners in the community, including healthcare facilities and state and local health departments; with other federal agencies; and with IT resources. Value in NHSN s responsiveness not just as a program but to individual practitioners in the field But also consensus that improvement is important, needed, and possible. from HICPAC
Potential areas of focus for improvement (1/2) Definitions A traditional area of focus that remains important Tension between being nimble and having consistency in definitions Simplicity The complexity of NHSN for a new hospital with a single IP is just too great. Definitions themselves are really complicated What are the tradeoffs of good enough definitions? from HICPAC
Potential areas of focus for improvement (2/2) Leveling the playing field: Risk adjustment today is extremely limited. Desire for improved, patient-level risk adjustment but recognize interpretability issues Identifying gaming/manipulation (whether intentional or unintentional) Automation and learning Concerns about lack of inter-rater and inter-facility agreement, potentially addressable by algorithmic, electronically implementable definitions Several spoke to the of electronic, non-manual NHSN reporting but also raised serious concerns about data validity (e.g. given experience with LABID) Consider intentional, prospective observation for unintended consequences with definition changes from HICPAC
hip Goal is to hit here, not over or under Effectiveness # from HICPAC
hip The group spent a significant amount of time discussing potential additional voices to consider for additional expertise/representation: CDC has already reached out to CMS to participate Office of the National Coordinator for Health Information Technology Pharmacist from a state health department or a healthcare facility Additional clinical microbiologist Representation from the front-line IT workflow perspective Patient representation Other groups involved in large-scale quality reporting Large EHR vendors Additional representation from hospital associations from HICPAC
Prompts 1 Composition: Who else should be part of the, if anyone? 2 Prioritization: If the accomplished the two most important things in the next 12 months, what would they be? from HICPAC