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HAI Clinical and Financial Implications and Policy Future

HAI Clinical and Financial Implications and Policy Future. Peter B. Angood, MD, FRCS(C), FACS, FCCM Senior Advisor, Patient Safety, National Quality Forum Member of Safe Practices Steering Committee Former Chief Patient Safety Officer and Vice President for The Joint Commission

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HAI Clinical and Financial Implications and Policy Future

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  1. HAI Clinical and Financial Implications and Policy Future Peter B. Angood, MD, FRCS(C), FACS, FCCM Senior Advisor, Patient Safety, National Quality Forum Member of Safe Practices Steering Committee Former Chief Patient Safety Officer and Vice President for The Joint Commission Safe Practices Webinar February 18, 2010

  2. Background: Impact of HAIs • 5%-10% of hospitalized patients develop an HAI • 99,000 deaths per year • $20 billion per year1 • Risk of serious HAI complications is highest for patients requiring intensive care • Increasing number of HAIs • Sicker patient population • More complex procedures and equipment • Increasing antimicrobial resistance 1Stone PW, et al. AJIC 2005; 33:501-5

  3. Estimated Number of Healthcare-Associated Infections in U.S. Hospitals by Subpopulation and Major Site of Infection, United States, 2002 Klevens, Edwards, Richards, et al. Pub Health Rep 2007;122:160-6

  4. 263,810 274,098 -967 -21 -28,725 244,385 TOTAL HRN WBN Non-newborn ICU = SSI 133,368 Other BSI 22% 11% SSI 20% UTI PNEU 36% 11% 424,060 129,519 Calculation of Estimates of Healthcare-Associated Infections in U.S. Hospitals Among Adults and Children Outsideof Intensive Care Units, 2002 HRN = high-risk newborns; WBN = well-baby nurseries; ICU = intensive care unit; SSI = surgical-site infections; BSI = bloodstream infections; UTI = urinary infections; PNEU = pneumonia Klevens, Edwards, Richards, et al. Pub Health Rep 2007;122:160-6

  5. What Are the Costs of Healthcare- Associated Infections? • U.S. • Total excess costs $32 million to $825 million annually • Most costs not reimbursed when DRGs are used or if costs are capitated • Preventing 6% of nosocomial infections offsets cost of $60,000 I.C. program • UK = cost £111 million/year and 950,000 lost bed days (1987) • Decrease NI rate by 20%, saves $15 million - $16 million

  6. NQF Safe Practices – 2010: Healthcare-Associated Infections 19. Hand Hygiene • Influenza Prevention • CLABSI Prevention • Surgical-Site Infection Prevention • Care of the Ventilated Patient • MDRO Prevention • Catheter-Associated UTI Prevention

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