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New Neuro ICU Provides State-of-the-Art Services

DALLAS — Parkland Memorial Hospital in Dallas opened a new state-of-the-art Neuro ICU, which will replace the old and outdated facility. The previous Neuro ICU provided great care to the patients, but was not the greatest healing environment. The ICU was very congested with equipment, doctors, nurses, other medical professionals and loved ones, said Christiana Hall, MD, medical director, Neuroscience ICU at Parkland and associate professor of Neurology, Neurotherapeutics and Neurosurgery at The University of Texas Southwestern Medical Center, in a statement.

The new Neuro ICU provides a family-friendly environment that is a perfect atmosphere for the patient’s healing process. “In the new Neuro ICU, every patient has a private room, nursing is decentralized, care teams have ample work space and the overall environment is serene, family-friendly and patient-focused,” said Kelly Heathman, RN, director of nursing, neuroscience at the hospital, in a statement.

The new ICU design was built using an evidence-based design and includes advanced technology features such as single-patient rooms with private bathrooms, including a shower and a family area with a sleeper sofa so the family is able to be involved in the patient care. The rooms also feature a ceiling-mounted boom that is designed to specifications from the Neuro ICU team. The equipment can be easily moved out of the way to facilitate care such as placing ventricular drains, according to a statement. The department also contains a dedicated CT scanner that will minimize transportation time and the distance to imaging services, which is meant to protect the patient’s safety. Each room will be fit with state-of-the-art “smart” rooms and “smart” beds that will be able to weigh the patients and even alert staff when a patient attempts to get out of bed. The addition of state-of-the-art technology allows the physicians to provide more efficient care for their patients.

Open work areas will facilitate staff interactions across the neuroscience disciplines, which will enhance patient care and safety. The staff will also now be equipped with special phones that will allow for secure texting of protected health information, eliminating the need for paging and callback and saving critical time with patients, according to a statement. Many of the new features at the Parkland Memorial Hospital Neuro ICU are included to be able to improve function and make the facility a more comfortable and family-friendly environment for patients.

“The appreciation we get from patients and families is very heartening. It’s one of the reasons many of us choose to practice at Parkland. Our patients make us grow, and we are grateful for it,” said Michael Rubin, MD, Neuro-Intensivist at Parkland and assistant professor of neurology and neurotherapeutics at UT Southwestern, in a statement.

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Prospect Medical Holdings Acquires Crozer-Keystone Health System

SPRINGFIELD, Pa. — An agreement was made between Crozer-Keystone Health System and Prospect Medical Holdings Inc. for the acquisition of Crozer-Keystone by Prospect, according to a statement from Prospect Medical Holdings. Although the two systems are merging, many things will stay the same for Crozer-Keystone hospitals, including their name.

Prospect has committed to investing at least $200 million in the Crozer-Keystone system over the next five years, which will help keep the five hospitals in the health system open. The capital investment will also increase the systems ability to modernize its facilities, allowing the hospitals to attract more patients and expand the services they are able to provide to the surrounding community. Prospect will also fund wellness, health education and other community programs in place at Crozer-Keystone, and will also adopt the hospital’s charity care policies for at least five years, according to a statement.

“We are very pleased to have a partner that shares so many of our priorities. We recognize and appreciate the level of commitment and the willingness to take on challenges that Prospect has demonstrated throughout the process of negotiating this agreement,” said Joan K. Richards, Crozer-Keystone president and CEO, in a statement.

The agreement states that service lines such as the Emergency Department, trauma, behavioral health, maternity and pediatrics will remain in place or expand. “Prospect is committed to building upon Crozer-Keystone’s long and distinguished history of delivering quality, compassionate care and to helping ensure the future of this vital community health care provider,” said Thomas Reardon, president of Prospect East Holdings Inc., in a statement.

Per the agreement, Prospect will assume Crozer-Keystone’s pension liability by funding $100 million of the obligations at closing and will provide distribution to pay all benefits owed to pension participants and beneficiaries within five years. The employees of Crozer-Keystone have no need to worry as Prospect will offer employment to all of those in good standing who are current at the closing date of the agreement at Crozer-Keystone. Prospect will also honor seniority levels and will enter into agreements with the labor organizations to which the employees of Crozer-Keystone belong.

Although Prospect committed to allowing Crozer-Keystone to operate similarly to how they were operating before, the acquisition means that Crozer-Keystone will now be a for-profit organization instead of a not-for-profit. This means that their tax status will change, and on top of being one of the region’s largest employers, the health system will become a large contributor to local and county tax revenues, according to a statement. Although it will now be a for-profit hospital, it will still be required to adhere to the same standards as a not-for-profit hospital.

“Our partnership with Prospect Medical, as embodied in this definitive agreement, delivers a solution that will be very good for Crozer-Keystone, its people, and it’s community,” said Bruce Fischer, chairman of the Crozer-Keystone Board of Directors, in a statement.

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UVA & Novant Health to Finalize Joint Venture

CHARLOTTESVILLE, Va. — The University of Virginia (UVA) Health System, located in Charlottesville, and Novant Health, headquartered in Winston-Salem, N.C., are working out the final details of a joint venture. This would bring the Northern Virginia community hospitals associated with both health systems into one system.

“We believe a joint operating company will help ensure patients throughout Northern Virginia receive quality care at the right time and the right place, while also providing care in a more efficient manner,” said Richard P. Shannon, MD, UVA’s executive vice president for health affairs, in a statement. “Novant Health has a long track record of successfully managing community health systems, making them an ideal partner for this alliance.”

The two systems are deciding on the details and what the partnership would entail and expect for the new system to be up and running in December, according to Triad Business Journal. In March, it was announced that the two systems were looking into creating a regional health care system together that would cover all of Northern Virginia.

Representatives from both UVA Health System and Novant Health signed a non-binding letter of intent in March as well and started to discuss what the joint operations would mean for the companies. The agreement would include UVA Culpeper Hospital and all of the Novant Health Virginia facilities, including Novant Health Haymarket Medical Center, Novant Health Prince William Medical Center and Novant Health Cancer Center, according to a statement. The discussion also included how Novant Health and UVA Health Systems can “integrate or coordinate cancer care across Northern Virginia, increasing access to UVA’s subspecialty cancer care through the regional health system,” according to a statement from UVA Health System and Novant Health.

“Through this new regional health system, patients will be able to connect with the expertise UVA provides as an academic medical center, including subspecialty care and potential breakthrough treatments through clinical trials, while benefitting from Novant Health’s experience with increasing access to care when and where patients need it,” said Carl S. Armato, president and CEO of Novant Health, in a statement.

According to Novant Health, it will keep 60 percent ownership over the venture, and the employees of the two systems will continue to be employed by the same health system, even though the systems are joining together and expanding. “Novant Health has a strong presence in Northern Virginia, and this proposed partnership only strengthens our ability to identify best practices, advance our population health strategy and lower health care costs,” Armato said in a statement.

Novant Health is seeking to expand its system and partnerships and is exploring collaborating with other academic medical centers, including Duke University Health System, according to Triad Business Journal. Novant Health believes that collaborating with other systems is a great way to grow and expand its knowledge and the services that it is able to offer, according to Armato.

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Baptist Memorial Hospital Begins Construction

OXFORD, Miss. — In 2012, Oxford was named the 15th fastest growing small town in America by Forbes magazine, which has prompted the local Baptist Memorial Hospital-North Mississippi to construct a larger facility in the area. According to the United States Census, the population in Oxford has grown by 15.3 percent since 2010. With the increased population in the area and the growth of local businesses and housing, the new hospital became essential.

“With the growth our area has experienced in the last decade, building a newer, updated hospital to serve the community became an easy decision,” said William Henning, administrator and CEO of Baptist Memorial Hospital in a statement.

Although the bed count of 247 will remain the same, the new space will be larger and more robust, according to Henning. “We will have the space to add new services, the flexibility for future changes in patient care and the infrastructure for new technology,” he said in a statement.

The former Baptist Memorial Hospital sat on a 13-acre lot, but the new campus will sit on a 150-acre lot, which will accommodate for the expansion and upgrades. The size of the hospital will also greatly differ as it grows to accommodate the new population. Henning has said that the construction of the new hospital will cost around $300 million.

Although the hospital will not have a greater number of beds, the focus of the project is to give the hospital a more contemporary, technologically advanced hospital for the community, according to Henning. “Everyone wants to be in Oxford. As Baptist brings more physicians and adds specialties to the area, it reduces the need for locals to travel outside of Oxford,” Henning said in a statement.

The new Baptist Memorial Hospital should be complete and fully operational by December 2017, according to Jondi Roberson, director of marketing and provider relations in The DM Online. “We are projected to take our first patients as of Dec. 1 of 2017. As far as when we will shut this hospital down, I am not sure when we will be completely out of this hospital. I assume sometime shortly thereafter,” Roberson said.

Decisions as to what will happen to the current hospital have yet to be made, but according to Roberson, the hospital is set to go up for sale. If the hospital is not sold, Baptist Memorial will be responsible for turning the former site into a green space for the community.

“The future looks bright. We are committed to providing the high-quality health care that our community deserves,” Henning said.

The administration and staff are excited about the new hospital and believe that the new, updated hospital will provide them with a great new opportunity to serve Oxford Better, according to The DM Online.

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Telehealth Continues to Show Success

INDIANAPOLIS — Bryan Mills, CEO of the Community Health Network hospital system in Indiana, has been promoting the use of telehealth in hospitals for years. Telehealth, a system of using videoconferences and the Internet to administer medical attention, has started to become more prevalent in the modern-age of medicine.

An Indianapolis-based health care service, Community Health Network, has been delivering mental health services online for many years already. They have mainly worked with smaller hospitals in their emergency departments where they are able to help mentally ill patients during a health crisis. He believes that telehealth, sometimes referred to as telemedicine, could work for patients who are suffering from a chronic illness such as diabetes, hypertension, asthma and mental illness, according to an interview gave to the Indianapolis Business Journal.

If telehealth continues to be successful, health care providers will be able to provide services and improve patient experience over the phone or videoconference, then the number of hospital stays and the amount of surgeries will decrease. If this occurs, hospital systems will no longer need new buildings to hold patients and provide services. “We believe that there’s a lot of things that we do that we could do virtually,” Mills said to the Indianapolis Business Journal.

Although telehealth is starting to be considered more as a viable option, in the past year, the health care construction related projects in Indiana have almost doubled, according to Revista, a Maryland-based market research firm.

According to the Indianapolis Business Journal, hospitals are becoming more comfortable with the changes made by Obamacare. The requirements to have health insurance and the aging population have brought more people to hospitals and into the health care system. The increase in patients has caused the hospitals to look for ways to handle the larger demand for health care and many health care systems are trying to use telehealth to decrease the amount of space needed for the patients. The Affordable Care Act has also encouraged facilities to see fewer patients, which makes telehealth an alternative for seeing patients.

A Los Angeles-based market research firm, IBISWorld has said that the revenue for telehealth will increase drastically, by almost 40 percent a year, through 2020 to revenue of $3.5 billion. “The industry has clearly hit a point where consumers are demanding it, employers see it as a cost savings, and insurers are more and more pushing it as a benefit. We think it’s going to grow tremendously,” said Ryan Daniels, analyst with William Blair & Co., in a statement.

On Oct. 8, the American Medical Association (AMA) announced that it will be encouraging digital medicine in clinical practices to adapt to the new telehealth system. They plan on having a sponsored group that will work with the practices to integrate the new technology in the Current Procedural Terminology (CPT) codes.

“Ensuring that CCPT codes accurately reflect the telehealth services provided to patients is only possible through the dedication and direct input of the advisors on the Telehealth Service Workgroup,” said AMA President Steven J. Stack, M.D., in a statement. “Tapping into the clinical and technological expertise of the health care community and innovators produces the practical enhancements that CPT needs to reflect the coding demands of the modern health care system.”

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Three Strategies to Optimize Your Operating Room

In operating room (OR) optimization, just as in a lifesaving surgical procedure, every minute counts. Small improvements in OR efficiency over the course of a year add up to substantial time and cost savings for a healthcare organization.

In a blended OR, typically, 60 to 80 percent of surgical cases are outpatient cases and the remaining 20 to 40 percent are inpatient cases. Because of their high predictability, surgical managers are able to schedule outpatient cases on a daily basis.

Efficient staffing and block scheduling, the standardization of OR equipment, supply and technology considerations, and layout optimization are three strategies that help improve OR scheduling and operations.

Staffing and Block Scheduling
When an OR physician is on a block schedule, they are able to schedule as many cases as can be accommodated. This often leads to idle periods in the OR, as other physicians are not able to schedule surgery unless that time is yielded to them. This forces add-on cases, which increases staff and labor costs. On the other hand, if every block is efficiently filled — yet there are still add-on cases due to high volume — this can cause capacity issues. A physician will have to push a case to a later time after block scheduling has ended. Whether the reason for lack of OR availability is inefficient block scheduling or high volume, the add-on cases drive up labor costs as an OR team has to work longer hours.

The more efficient a hospital is with OR time, the less revenue they will lose on costs of labor and facilities. The most cost-effective staffing solutions are based on predictive analytics, which analyze data in hospital’s high-traffic departments. This information, along with bed census data, allows surgery-scheduling managers to quantify case volume and structure staffing to volume and manage labor costs.

Computer simulation is an effective tool to analyze which type of procedure would be best for individual cases. It allows hospitals to assess the most effective and timely way to proceed during a surgery. The hospital is able to identify longer procedures and standardize components to avoid scheduling back-ups and overtime costs.

A surgeon may also not be performing at capacity during their block. The obvious solution is to increase the surgeon’s case volume or decrease block time. However, it is more effective to analyze trends and share the data with the physician instead of giving them an ultimatum. Working with the surgeon, asking about their capacity challenges, or offering time each day for add-ons and urgent cases will persuade most surgeons to adjust.

A partnership is fundamental to improving efficiency in the OR. This requires both the hospital and surgeons to find solutions for staffing efficiency in order to share benefits, including convenience, assigned staff, amenities and new technology.

Standardization
Standardization of equipment and supplies, technology and layout is a third strategy to optimize the OR. Even if the OR is running at peak capacity and surgical staff are well aligned with the volume and types of cases, OR teams must be supplied with the quantity, type and preferred equipment for procedures.

A physician’s preference card for supplies reflects their procedure needs, but due to limited inventory on some more expensive equipment, scheduling can be tight. The absence of tools and supplies the physician is most familiar with can slow down a procedure, causing scheduling challenges.

The solution lies in standardization of equipment and supplies to the greatest extent possible while satisfying physician preferences. By presenting inventory and cost data to the surgeons’ council, they will be able to see that unused inventory equals dollars lost. Although most physicians do not have a direct financial stake within the hospital surgery department, the savings would be able to benefit them by decreasing procedure times and reducing staffing inefficiencies. When equipment and supplies are standardized based on procedure, staff is able to prepare carts for procedures the next day and make them readily available.

Standardization of OR technology and physical layout have also improved efficiency and reduced cost as well as improving ergonomics and reducing employee fatigue and accidents. The physical layout uses a strategy based on concentric circles: a clean core for sterilized equipment surrounded by ORs and an outer ring comprised of stretcher holding bays, scrub alcoves and support spaces. The sterilized standard equipment is always available at the core and allows surgeons to move from one OR to another once they have scrubbed into the sterilized area. This standardization would enable surgical teams to operate more efficiently and streamline their procedures, saving money and increasing patient outcomes and staff satisfaction.

As Director of Strategy at Chicago-based health care consulting and design firm FreemanWhite, Michelle Mader collaborates with healthcare leaders to achieve high-level performance and identify profitable market opportunities.

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Ways to Prevent Hospital Acquired Diseases

By Robert Kravitz

The word hospitalism was coined back in the 1830s by the Scottish doctor James Simpson. The term was developed to help identify a growing problem in many hospitals in northern Europe: people who acquired new diseases while in the hospital.

Today, we refer to such diseases as hospital acquired diseases, nosocomial infections, or hospital associated infections (HAI). Back in the 1830s, the prevailing theory as to the cause of HAI was poor ventilation and stagnant air. Because few doctors believed in germ theory, as it was called at that time, the way most doctors suggested addressing HAI outbreaks was to simply open the window.

Today, although we know much more about HAI, it is still a major problem in hospitals around the world. It is believed HAIs are incurred by as many as one in 20 patients admitted to hospitals, affecting more than 1.7 million patients each year. We also know that simply opening a window will do little to prevent HAIs.

Instead we now know that one of the key culprits for the spread of HAIs is lack of proper hygiene. In some cases, hospital staff have become complacent, not following proper hand washing protocol or exhibiting improper use or removal of gloves. In many, if not most, cases, HAIs are caused by inadequate or improper cleaning and maintenance of all types of hospital surfaces, most often patient bathrooms.

HAI Statistics

Before exploring ways to prevent HAIs, we should know a little more about them and their impact on hospitals and patients. For instance, in the United States, the cost to treat an HAI is more than $40,000 per patient, and increasingly these costs must be absorbed by the hospital. Government agencies and many insurance companies will no longer cover the cost of treating HAIs.

Other HAI stats worth knowing include these:

Most patients who acquire an infection spend an extra 20 days in the hospital recovering.

Each year, 5 percent to 10 percent of the patients entering an acute care hospital acquire one or more infections there.

About 100,000 people die each year in the U.S. due to HAI.

HAIs are the sixth leading cause of death in the U.S.

As many as 70 percent of all HAI cases are preventable.

The commitment of all hospital and medical staff is needed to address the problem. Increasingly, prevention will be the job of hospital housekeeping and environmental services teams who now realize, more than ever before, that the goal of their work is to protect human health. Appearance, although still important, is no longer their paramount concern.

New Cleaning and Inspection Technologies

Because HAIs continue to be a menace, medical facility administrators and housekeeping staff may need to review all cleaning tasks, evaluating their cost and effectiveness. Some major changes may be necessary in some cases.

Studies presented at the nonprofit Cleaning Industry Research Institute report for instance, that some conventional cleaning tasks, such as mopping floors and using traditional cleaning cloths, actually spread as many pathogens that can cause HAIs as they remove. With mopping, this occurs even when using a double-bucket system, which is designed to keep cleaning solution, rinse water, and the mop itself cleaner and more hygienic.*

Several promising cleaning technologies have been introduced in the past decade that may help prevent HAIs. Some of these include the following:

Vapor technologies: These machines clean by releasing a mist onto surfaces such as bed rails, tables, countertops, doorknobs and window ledges. Cleaning chemicals, hydrogen peroxide, and disinfectants can be added to the solution to help kill stop bacteria.

Flat surface cleaning systems: These systems combine a chemical injection system, a microfiber wipe and a window squeegee to clean flat surfaces. The key benefit of flat surface cleaning systems is that they tend to speed up the cleaning process and do not spread contaminants from one surface to another the way cleaning cloths can. Additionally, studies indicate that microfiber cloths, mops and flat surface cleaning systems, can significantly reduce contaminants compared to traditional cloths or string mops.

Spray-and-vac cleaning systems: Initially designed for cleaning restrooms, these systems can now be used for a variety of cleaning tasks. With a spray-and-vac system water and/or cleaning solution is applied to surfaces.** If using chemicals, the chemicals must stay on the surface for a few minutes. The same areas are then pressure rinsed and the vacuum portion of the machine vacuums up any remaining moisture.

With these cleaning technologies, cleaning teams can now measure the hygienic effectiveness of their cleaning tasks to determine whether surfaces meet cleaning standards. Adenosine triphosphate (ATP) technology has been used for years to test if a surface is hygienically clean in laboratories, grocery stores, and other locations.

ATP is an energy molecule stored in all microorganisms. The technology does not detect specific organic substances but a high ATP reading is typically viewed as a warning that potentially harmful pathogens are present on a surface.

Cost Comparisons

There are many reasons why facilities have continued to select traditional cleaning tools. One is that they are known and have been used for years. Another is that, for the most part, they are inexpensive. A mop and bucket may cost less than $40 dollars.

Selecting the new cleaning technologies mentioned here may cost more initially, but hospital administrators must decide if the added costs associated with the HAIs are worth the investment. If they help stop HAIs, then the answer is yes. Helping to make the added costs more palatable, most studies indicate that these systems reduce cleaning times—a labor savings that can result in a relatively quick return on investment.

*Studies indicate that we have as many as 50 direct and indirect contacts with floors every day. Each time we retrieve a purse, briefcase, or pen from the floor, we may come in contact with pathogens on the floor.

Robert Kravitz is a writer for the professional cleaning, education, hospitality and health industries. He may be reached at info@alturasolutions.com

**Some spray-and-vac systems do not need chemicals but have been labeled as “sanitizing devices,” meaning they meet EPA standards for sanitizing without using chemicals.

Sources: Agency for Healthcare Research and Quality, part of the U.S. Department of Health and Human Services

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Electronic Faucets Can Cause Infection, Study Finds

BALTIMORE, Md. – A study of newly installed hands-free faucets at The Johns Hopkins Hospital, all equipped with sensors to automatically detect hands and dispense preset amounts of water, shows they were more likely to be contaminated hazardous bacteria compared to traditional fixtures with separate handles for hot and cold water.

Although the high-tech faucets cut daily water consumption by more than half, Johns Hopkins researchers identified Legionella growing in 50 percent of cultured water samples from 20 electronic faucets in or near patient rooms at three different inpatient units. Legionella was found in only 15 percent of water cultures from 20 traditional manual faucets in the same patient care areas.

Weekly water culture results also showed half the amount of bacterial growth of any kind in the manual faucets than in the electronic models.

While the precise reasons for the higher bacterial growth in the electronic faucets still need clarification, researchers said it appears that standard hospital water disinfection methods, which complement treatments by public utilities, did not work well on the complex valve components of the newer faucets. They suspect that the valves simply offer additional surfaces on which bacteria become trapped and grow.

The Johns Hopkins researchers presented their findings at the annual meeting of the Society for Health Care Epidemiology in Dallas.

The electronic fixtures were widely introduced in patient care and public areas of hospitals across the United States, including in The Johns Hopkins Hospital, more than a decade ago. The idea was to prevent the spread of bacterial from people touching the faucet’s handles with their dirty hands.

As a result of the study, conducted over a seven-week period from December 2008 to January 2009, Johns Hopkins facilities engineers removed all 20 newer faucets from patient care areas and replaced them with manual ones. A hundred similar electronic faucets also are being replaced throughout the facility, and hospital leadership elected to use traditional fixtures – some 1,080 of them – in all patient care areas in the clinical buildings currently under construction on Johns Hopkins’ East Baltimore campus. The buildings are set to open in 2012.

Lead study investigator Emily Sydnor, a fellow in Infectious Diseases at Johns Hopkins, said Legionella bacteria, commonly found in water supplied by public utilities, rarely cause illness in people with healthy immune systems but pose a real risk of infection in hospital patients whose immune systems are weakened from cancer chemotherapy, anti-rejection drugs taken after organ transplant or diseases such as HIV/AIDS. Whilst some of these people may find that taking vitamin c liposomal boosts their immune system during these trying times, others may struggle regardless.

Sydnor says that this is why some hospitals, including Johns Hopkins, treat water supplied by public utilities with chlorine dioxide or other methods to keep Legionella levels low.

Co-investigator Gregory Bova, a senior engineer at Johns Hopkins, said the original goal of the research team, was to test the new faucets to determine how often and for how long treated water needed to be flushed through the hospital’s taps to keep Legionella and other bacteria at nearly undetectable levels.

As part of the study, Bova and his team disassembled four of the electronic faucets and their component parts, two before the water was treated and two afterward, with swab culture tests showing Legionella and other bacteria on all the main component valves and other parts, very few of which exist in manual faucets.

Researchers said their next steps are to work with manufacturers of electronic and manual faucets to help remedy their flaws and design components that can be cleaned more easily and save water. They have also notified infection control staff at other hospitals of their findings.

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Surgery Infection Rates Made Public Online

SEATTLE — The Washington State Hospital Association has begun releasing hospital-specific surgical infection rate data public for the first time. The release of information comes as a result of the Washington State Legislature requiring the data to be collected and made public in 2007. By law, hospitals are required to report into an electronic database reporting infection rates for cardiac, hysterectomy, and orthopedic procedures. The website allows users to sort hospitals by county, alphabetically, and from highest too lowest or lowest to highest infection rates.

“The web site provides a resource for hospitals to benchmark their own achievements against and provides a resource for best practices,” says Beth Zborowski, director of Program Communications at WSHA. “For example, if a hospital was experiencing infections in one surgical area, they could look at similar hospitals who were performing better and find out what strategies were being used to prevent infections there.”

Zborowski said that increasing transparency is a future trend for infection rates as well as other quality indicators, and reporting should be on evidence-based measures that are proven to have an impact on patient outcomes. She added that if the reporting does not result in improvements in patient care, then they are pointless.

“Right now, hospitals are required to report a ton of data to a wide variety of organizations, from federal and state government to national improvement organizations,” Zborowski said.

“Sometimes hospitals are reporting on the same measure, but there is a slightly different definition of way the information must be reported, creating an additional administrative burden and cost for hospitals. Ideally, a set of national, evidence-based measures should be developed. This would also give hospitals across the country national best practice benchmarks — something that is not currently available for infection rates.”

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