National Healthcare Safety Network Central Line-Associated Blood Stream Infection (CLABSI) Outcome Measure
Standardized Infection Ratio (SIR) and Adjusted Ranking Metric (ARM) of healthcare-associated, central line-associated bloodstream infections (CLABSI) will be calculated among patients in bedded inpatient care locations. This includes acute care general hospitals, long-term acute care hospitals, rehabilitation hospitals, oncology hospitals, and behavioral health hospitals.
ACP supports NQF measure #0139: “National Healthcare Safety Network Central Line- Associated Blood Stream Infection (CLABSI) Outcome Measure.” This measure represents an important clinical concept and implementation will likely lead to meaningful improvements in clinical outcomes. While we support this measure, we note two suggestions for developers to consider when submitting the measure to NQF for re-endorsement. First, national CLABSI rates are already low and it may be difficult for facilities to score 100% on this measure. Rather than using this measure to compare performance across facilities, accreditors and regulators should set a national standard for acceptable CLABSI rates and require all facilities to meet this standard. Otherwise, if accreditors and regulators push facilities to achieve an unreasonable rate, implementation could result in harm by discouraging clinicians from obtaining cultures and encouraging overuse of antibiotic therapy. On the other hand, if accreditors and regulators stratify performance results by facility, and low performers implement quality improvement efforts to improve CLABSI rates, implementation will lead to meaningful improvements in clinical outcomes. Second, the reporting burden associated with this measure is high and could result in under- or over-estimation of CLABSIs rates. We encourage developers to work towards minimizing this burden when they submit the measure to NQF for re-endorsement.