CDC Expanding Quality of Care Efforts
The NHSN, which evolved in 2000 from what was the much more narrowly focused National Nosocomial Infections Surveillance System created decades earlier, started with only 300 participating hospitals.
Today, it collects reports from more than 12,000 medical facilities, including hospitals, ambulatory surgical centers, dialysis treatment centers skilled nursing facilities, and long-term acute care settings.
That number is expected to grow as state and federal mandates evolve. So far, data collection has expanded from hospital ICUs to acute care settings. In total, 31 states and the District of Columbia now require hospitals to report to NHSN.
In a recent interview with HealthLeaders, Denise Cardo, MD, director of the CDC's Division of Healthcare Quality Promotion, answered questions about what hospital systems and doctors can expect going forward. The interview was edited for clarity.
HLM: It seems that recently the CDC has been moving beyond areas of public health with efforts to define how care is delivered, how quality is measured, and what improvements we should expect from healthcare reform, among other initiatives. Is that off-base, or has the CDC's role changed?
Cardo:I wouldn't use the word "changed," but rather evolved and expanded. And it's not just the past few years. We are responsible for the health of the nation, and that's not just in a community, but also in healthcare. And as you know, one depends on the other. Our director, Tom Frieden, is very clear about the connection between healthcare delivery and public health.
HLM:But the CDC's role seems to be different today, with the expansion of the NHSN, antibiotic stewardship, and other types of harm prevention. That's not a space you used to be in, right?
Cardo:We were, but more with outbreaks. And we worked with healthcare settings, but the impact of our work was not as great as it is now, and the scope of activities not as big.
A decade or so ago, people in healthcare thought of healthcare infections as an acceptable complication. Science at the time said we might be able to prevent only 30%.
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