Patient Safety Initiatives
Thank you for your interest in new patient safety initiatives! There are two measures currently under consideration for inclusion in the Medicare program – one related to blood culture contamination (BCC), the other related to hospital onset bacteremia (HOB). Both measures would directly improve patient safety during critical care.
Improving Blood Culture Contamination Standards
Blood culture contamination (BCC) and ensuing false-positive sepsis diagnoses affect an estimated 800,000 Americans every year.14 Sepsis is the leading cause of death, costs, and readmissions in U.S. hospitals.15 Blood cultures are the standard for diagnosing sepsis. Yet, between 20% and 56% of positive blood culture results are false-positives.16 Often, false-positive results are caused by sample contamination that can occur during the specimen collection process. A recent study published in a leading peer-reviewed medical journal reported a 74 percent increase in in-hospital mortality for patients that had a false-positive blood culture test for sepsis as opposed to those patients that had an accurate negative test result.17
Approximately $8.5 billion is unnecessarily spent each year in the U.S. on inappropriate treatments and associated preventable complications directly attributable to false-positive blood culture results. False-positives often result in patients being treated with antibiotics, which contributes to the crisis of antimicrobial resistance.
Improving hospital onset bacteremia standards
Hospital-Acquired Conditions (HACs) are conditions that a patient develops while in the hospital being treated for something else. These conditions cause harm to patients.
The Hospital Onset Bacteremia (HOB) measure, proposed by the Centers for Disease Control and Prevention’s (CDC) National Healthcare Safety Network (NHSN), is under consideration for inclusion in the HAC program. The national consensus-based entity has endorsed it as being valid and reliable, while the Measures Application Partnership has recommended it for inclusion in the Medicare program. If adopted, it would provide for a similar incentive to improve patient safety by reducing rates of hospital-onset bacteremia. However, the HOB measure is broader than just BCC as it includes other metrics related to bacteremia. Thus, while the HOB measure may provide for improved reporting requirements, the impact on BCC – may be diluted.