title: Taking advantage of public reporting: An infection composite score to assist evaluating hospital performance for infection prevention efforts.
abstract: The standardized infection ratio (SIR) evaluates individual publicly reported health care-associated infections, but it may not assess overall performance.
  
  
  
  We piloted an infection composite score (ICS) in 82 hospitals of a single health system. The ICS is a combined score for central line-associated bloodstream infections, catheter-associated urinary tract infections, colon and abdominal hysterectomy surgical site infections, and hospital-onset methicillin-resistant Staphylococcus aureus bacteremia and Clostridium difficile infections. Individual facility ICSs were calculated by normalizing each of the 6 SIR events to the system SIR for baseline and performance periods (ICSiband ICSip, respectively). A hospital ICSibreflected its baseline performance compared with system baseline, whereas a ICSipprovided information of its outcome changes compared with system baseline.
  
  
  
  Both the ICSib(baseline 2013) and ICSip(performance 2014) were calculated for 63 hospitals (reporting at least 4 of the 6 event types). The ICSipimproved in 36 of 63 (57.1%) hospitals in 2014 when compared with the ICSibin 2013. The ICSib2013 median was 0.96 (range, 0.13-2.94) versus the 2014 ICSipmedian of 0.92 (range, 0-6.55). Variation was more evident in hospitals with ≤100 beds. The system performance score (ICSsp) in 2014 was 0.95, a 5% improvement compared with 2013.
  
  
  
  The proposed ICS may help large health systems and state hospital associations better evaluate key infectious outcomes, comparing them with historic and concurrent performance of peers.
authors.affiliation: Care Excellence, Ascension Health, St Louis, MO. Electronic address: Mohamad.Fakih@ascensionhealth.org.
authors.forename: Mohamad G
authors.initials: MG
authors.lastname: Fakih
authors.affiliation: Care Excellence, Ascension Health, St Louis, MO.
authors.forename: Boguslow
authors.initials: B
authors.lastname: Skierczynski
authors.affiliation: Care Excellence, Ascension Health, St Louis, MO.
authors.forename: Angelo
authors.initials: A
authors.lastname: Bufalino
authors.affiliation: Care Excellence, Ascension Health, St Louis, MO.
authors.forename: Clariecia
authors.initials: C
authors.lastname: Groves
authors.affiliation: Care Excellence, Ascension Health, St Louis, MO.
authors.forename: Phillip
authors.initials: P
authors.lastname: Roberts
authors.affiliation: Care Excellence, Ascension Health, St Louis, MO.
authors.forename: Michelle
authors.initials: M
authors.lastname: Heavens
authors.affiliation: Care Excellence, Ascension Health, St Louis, MO.
authors.forename: Ann
authors.initials: A
authors.lastname: Hendrich
authors.affiliation: Care Excellence, Ascension Health, St Louis, MO.
authors.forename: Ziad
authors.initials: Z
authors.lastname: Haydar
mesh_terms: D003428:Cross Infection / Q000453:epidemiology* / Q000517:prevention & control*; D006761:Hospitals; D006801:Humans; D017053:Infection Control / Q000379:methods*; D012308:Risk Management / Q000379:methods*
keywords: Health care–associated infection; composite score; performance measure; public reporting