Stewardship Metrics Flashcards
CMS denied reimbursement conditions
selected conditions arising as a result of the hospital stay that would result in denied reimbursement for services to hospitals after October 1, 2008. (2) The Centers for Medicare & Medicaid Services lists 14 categories of hospital- acquired conditions, including some infection-related conditions. (A) Catheter-associated urinary tract infections (B) Vascular catheter-associated infection (C) Surgical site infection after coronary artery bypass grafting, bariatric surgery for obesity, cardiac implantable electronic device, or orthopedic procedures includ- ing those related to the spine, neck, shoulder, or elbow
CDC AR module reports
AR module requires that isolate-based reports be submitted, including: (A) First isolate from an invasive source (blood or cerebrospinal fluid) per patient per 14 days (B) First isolate from a noninvasive source (lower respiratory or urine) per patient per month
Cost-benefit analysis
Converts varying methods into monetary values and then compares
Cost-effectiveness analysis
Evaluates relative costs and effects of comparative methods
Cost-consequence analysis
Observes different costs and effects of comparative methods
Cost analysis
Evaluates all costs but does not include effects
Cost-minimization analysis
Observes differences in costs while assuming similar effects between comparative methods
Cost-utility analysis
Evaluates costs and uses quality-adjusted life-years as effect for each comparison method
Patient-days
Number of admissions during designated time x average LOS
Days present
Aggregate number of patients in a patient care location at anytime during a day during a calendar month (essentially “DOT” for patient days); patients can account for a day present in more than one location during a day if transfer of care occurs
CDC recommendations for measuring abx use in outpatient settings
- The CDC has provided recommendations for monitoring antibiotic use in outpatient settings. a. Recommends to track antibiotic prescribing at the individual clinician level and provide targeted feedback and comparisons with peer prescribing rates, when possible b. Outpatient stewards may track the percentage of visits for which antibiotics are prescribed and compare these with peer average rates. If providing peer comparisons, the needs of the specific patient population(s) seen should be considered.
CDC recs for monitoring abx use in nursing homes
CDC has provided recommendations for monitoring antibiotic use in nursing homes. a. Antibiotic DOT is recommended if the facility has the resources to calculate this metric. i. May be presented as the antibiotic use ratio (antibiotic DOT divided by total resident-days) ii. May be standardized by dividing by 1000 resident-days (denominator similar to patient-days in acute care facilities) b. Point prevalence of antibiotic use should be measured to track the proportion of residents receiving antibiotics during a specified time.
