CMS Reveals Central Line Infection Rates, Finally

For checklist guru Peter Pronovost, MD, this is a week to pop open that bottle of expensive champagne—if he does that sort of thing.

That's because for the first time, the Centers for Medicare & Medicaid Services has added to its Hospital Compare website the rates of central line-associated bloodstream infections, or CLABSIs, for specific hospital intensive care units, at least those collected to date. 

Next to getting hospitals to pay more attention to their central line processes, that's what Pronovost, a Johns Hopkins intensivist, and his collaborators have worked toward for the better part of the last decade.

The Centers for Disease Control and Prevention estimates these terrible, but preventable infections killed 10,000 of the 41,000 patients who acquired them while being cared for in U.S. intensive care units in 2009. Providing the additional care the infections required added $700 million to the healthcare bill.

The scores are posted in two ways on Hospital Compare. In the first, each hospital is listed as better, worse, or no different than the national average for the first quarter of 2011, with a link to a graph comparing the hospital's rate to the state rate.

In the second, hospitals are listed by Standardized Infection Ratio scores ranging from no infections, (0) to a high rate (4.57).  The SIR compares the number of CLABSIs to a national benchmark, adjusted for the type and size of the hospital or ICU, indicating whether it is worse, better than or at the national benchmark. A score of 1 means the hospital's CLABSI score was no different than hospitals of similar type and size.