Health-Care-Associated Infections: HHS Action Needed to Obtain Nationally Representative Data on Risks in Ambulatory Surgical Centers
Highlights
Health-care-associated infections (HAI) are a leading cause of death. Recent high-profile cases of HAIs in ambulatory surgical centers (ASC) due to lapses in recommended infection control practices may indicate a more widespread problem in ASCs, but the prevalence of such lapses is unknown. The Department of Health and Human Services' (HHS) Centers for Medicare & Medicaid Services (CMS) and other entities collect data on HAIs, including process data on the use of recommended practices and outcome data on HAI incidence. CMS conducts standard surveys on about half of ASCs every 3 to 4 years, assessing compliance with its standard on infection control. In this report, GAO examines the availability of data on HAIs in ASCs nationwide. GAO interviewed subject-matter experts, agency officials, and trade and professional group officials.
Recommendations
Recommendations for Executive Action
| Agency Affected | Recommendation | Status |
|---|---|---|
| Department of Health and Human Services | To obtain nationally representative and standardized information on the extent to which ASCs implement specific infection control practices that reduce the risk of transmitting HAIs to their patients, the Acting Secretary of HHS should develop and implement a written plan to use the data collection instrument and methodology tested in the ASC pilot study, with appropriate modifications based on the CDC and CMS analyses of that study, to conduct recurring periodic surveys of randomly selected ASCs. |
In response to our recommendation, CMS required both state survey agencies (SAs) and accreditation organizations approved by CMS to use in their surveys of ambulatory surgical centers (ASCs) a revised version of the Infection Control Surveyor Worksheet developed for the ASC pilot study. This became a permanent part of the ASC survey process beginning October 1, 2009. In addition, to address our recommendation for a nationally representative sample, CMS identified a randomly selected subset of ASCs that each SA was required to survey in fiscal year 2010, and planned to conduct surveys on a comparable random subsample of ASCs in fiscal year 2011. HHS's actions led to a fourfold increase in the proportion of surveyed ASCs found to have deficient infection control practices, from 16.5 percent in fiscal year 2008 to 61 percent in fiscal year 2010.
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