HHS Releases 5-Year Plan to Decrease HAIs.

Yesterday the HHS released their 5yr plan to address hospital acquired infections. There is a comment period for this plan. It closes on Feb 6, 2009.

The press release is here: HHS HAI Press Release
The executive summary is here: HHS HAI Executive Summary
The contents page is here: HHS HAI Contents Page
Comments can be sent to (until 2/6/09): HAIComments@hhs.gov

The following excerpts are from the "Incentives and Oversight Group" section. It clearly shows the continuation of pay-for-performance, transparency, and public accountability:

Priority Recommendations of the Incentives and Oversight Group:

• Improve regulatory oversight of hospitals and CMS oversight of the hospital accreditation program by refining the current method of measuring Accreditation Organization performance, enhancing surveyor training and tools, and adding sources and uses of infection control data.
• Continue to incorporate measures of infection prevention and outcomes into Hospital Value-Based Purchasing (VBP) Plan methodology through implementing performance-based payment for hospitals, including measures of infection prevention and outcomes as a basis for payment.
• Expand measures in CMS Hospital Compare which improves the quality and transparency of hospital care by increasing public accountability and provides consumers access to important hospital quality of care measures.

The following recommendations would further strengthen the commitment to quality in the prevention of HAIs:

• Require that a hospital ensure that their infection control program follows currently recognized standards of practice as established by national organizations.
• Require that the infection control program be an integral part of the hospital’s quality assessment and performance improvement (QAPI) program. While the current Infection Control CoP does require that the hospital-wide quality assurance program address the problems identified by the infection control officer, this revision would more directly link the Infection Control CoP with the equally important QAPI CoP and would require hospitals to pursue a more proactive and innovative approach to infection control through their ongoing QAPI program.

Recommendations on how the Hospital VBP Plan methodology could incorporate measures of infection prevention and outcomes:

• Individual measures of infection prevention and outcomes, specified elsewhere in this report, could be scored for hospitals as part of performance assessment.
• Individual infection measure scores could be aggregated into a rollup infection measure for hospitals.
• Individual infection measure scores or a rollup infection measure could be aggregated into a roll up patient safety domain, which could be included in hospitals’ total performance scores. Thus, hospitals’ financial incentives would depend, in part, on their performance on measures of infection prevention and outcomes.
• Scores for individual measures, roll up infection measures, and the roll up patient safety domain could be reported on Hospital Compare as an infection scorecard for hospitals.

Each year, CMS will continue adding additional measures to Hospital Compare. These enhancements are part of HHS’ ongoing commitment to increased healthcare transparency. CMS is adding 13 new measures for the FY 2010 program, and retiring one existing measure. The inclusion of these additional measures will encourage hospitals to take steps to make care safer for patients.