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Use of Administrative Data in Efficient Auditing of Hospital-Acquired Surgical Site Infections, New York State 2009–2010

Published online by Cambridge University Press:  02 January 2015

Valerie B. Haley ,
Carole Van Antwerpen ,
Boldtsetseg Tserenpuntsag ,
Kathleen A. Gase ,
Peggy Hazamy ,
Diana Doughty ,
Marie Tsivitis  and
Rachel L. Stricof
Valerie B. Haley*
Affiliation:
New York State Department of Health, Bureau of Healthcare Associated Infections, Albany, New York
Carole Van Antwerpen
Affiliation:
New York State Department of Health, Bureau of Healthcare Associated Infections, Albany, New York
Boldtsetseg Tserenpuntsag
Affiliation:
New York State Department of Health, Bureau of Healthcare Associated Infections, Albany, New York
Kathleen A. Gase
Affiliation:
New York State Department of Health, Bureau of Healthcare Associated Infections, Albany, New York
Peggy Hazamy
Affiliation:
New York State Department of Health, Bureau of Healthcare Associated Infections, Albany, New York
Diana Doughty
Affiliation:
New York State Department of Health, Bureau of Healthcare Associated Infections, Albany, New York
Marie Tsivitis
Affiliation:
New York State Department of Health, Bureau of Healthcare Associated Infections, Albany, New York
Rachel L. Stricof
Affiliation:
New York State Department of Health, Bureau of Healthcare Associated Infections, Albany, New York Council of State and Territorial Epidemiologists, Atlanta, Georgia
*
Corning Tower Room 2580, Albany, NY 12237 ([email protected])
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Abstract

Objective.

To efficiently validate the accuracy of surgical site infection (SSI) data reported to the National Healthcare Safety Network (NHSN) by New York State (NYS) hospitals.

Design.

Validation study.

Setting.

176 NYS hospitals.

Methods.

NYS Department of Health staff validated the data reported to NHSN by review of a stratified sample of medical records from each hospital. The four strata were (1) SSIs reported to NHSN; (2) records with an indication of infection from diagnosis codes in administrative data but not reported to NHSN as SSIs; (3) records with discordant procedure codes in NHSN and state data sets; (4) records not in the other three strata.

Results.

A total of 7,059 surgical charts (6% of the procedures reported by hospitals) were reviewed. In stratum 1, 7% of reported SSIs did not meet the criteria for inclusion in NHSN and were subsequently removed. In stratum 2, 24% of records indicated missed SSIs not reported to NHSN, whereas in strata 3 and 4, only 1% of records indicated missed SSIs; these SSIs were subsequently added to NHSN. Also, in stratum 3, 75% of records were not coded for the correct NHSN procedure. Errors were highest for colon data; the NYS colon SSI rate increased by 7.5% as a result of hospital audits.

Conclusions.

Audits are vital for ensuring the accuracy of hospital-acquired infection (HAI) data so that hospital HAI rates can be fairly compared. Use of administrative data increased the efficiency of identifying problems in hospitals' SSI surveillance that caused SSIs to be unreported and caused errors in denominator data.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 33 , Issue 6 , June 2012 , pp. 565 - 571
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012 

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