title: The impact of Contact Isolation on the quality of inpatient hospital care.
abstract: BACKGROUND
  Contact Isolation is a common hospital infection prevention method that may improve infectious outcomes but may also hinder healthcare delivery.
  
  
  METHODS
  To evaluate the impact of Contact Isolation on compliance with individual and composite process of care quality measures, we formed four retrospective diagnosis-based cohorts from a 662-bed tertiary-care medical center. Each cohort contained patients evaluated for one of four Centers for Medicare and Medicaid Services (CMS) Hospital Compare process measures including Acute Myocardial Infarction (AMI), Congestive Heart Failure (CHF), Pneumonia (PNA) and Surgical Care Improvement Project (SCIP) from January 1, 2007 through May 30, 2009.
  
  
  RESULTS
  The 6716-admission cohort included 1259 with AMI, 834 with CHF, 1377 with PNA and 3246 in SCIP. Contact Isolation was associated with not meeting 4 of 23 individual hospital measures (4 of 10 measures were not met for care provided while patients are typically isolated). Contact Isolation was independently associated with lower compliance with the composite pneumonia process-of-care measure (OR 0.3, 95% CI 0.1-0.7). AMI, CHF and SCIP composite measures were not impacted by Contact Isolation.
  
  
  CONCLUSIONS
  Contact Isolation was associated with lower adherence to some pneumonia quality of care process measures of care on inpatient wards but did not impact CHF, AMI or SCIP measures.
authors.affiliation: Department of Epidemiology and Public Health, University of Maryland, School of Medicine, Baltimore, Maryland, United States of America. dmorgan@epi.umaryland.edu
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Morgan
authors.forename: Hannah R
authors.initials: HR
authors.lastname: Day
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Harris
authors.forename: Jon P
authors.initials: JP
authors.lastname: Furuno
authors.forename: Eli N
authors.initials: EN
authors.lastname: Perencevich
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003376:Counseling; D005260:Female; D006333:Heart Failure / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans; D007297:Inpatients; D016015:Logistic Models; D008297:Male; D008484:Medicaid; D006278:Medicare; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D010343:Patient Admission; D005791:Patient Care / Q000592:standards*; D010356:Patient Isolation / Q000592:standards*; D011014:Pneumonia / Q000453:epidemiology; D011787:Quality of Health Care / Q000592:standards*; D016540:Smoking Cessation; D014481:United States