Here is an article recently
published in ICHE which caught my attention. The study explores the impact of the CMS HAC Reduction program on central line associated bloodstream infections (CLABSI).
A brief summary of the CMS Hospital Acquired Condition (HAC) Reduction program can be found here.
The premise is that pay for performance with hospital to hospital ranking will improve safety and infection control outcomes such as CLABSIs.
Enhancing patient safety via performance incentives sounds logical however the data (to date) may not fully support this approach.
In the study referenced above, the investigators did not observe changes in the slope of CLABSI infection rates in the postpolicy period compared with the prepolicy period for either safety net (post HAC Reduction policy vs pre HAC Reduction policy ratio, 0.96 [95% CI, 0.84-1.09]) or non-safety net (0.99 [0.90-1.10]) hospitals. After controlling for secular trends, no impact in CLABSI rates by the CMS HAC Reduction program was detected (either positive or negative) on already declining rates of CLABSI across the nation.
We need need better long term data before we make these sorts of programs (with financial repercussions) permanent fixtures in the patient safety landscape.
