Hospital-acquired infections represent a significant cause of patient morbidity and mortality, and a driver of avoidable health care spending. To help improve our hospital outcomes, we monitor data concerning two common but serious in-hospital infections: central line-associated bloodstream infections and clostridium difficile (C. difficile, or C. diff) infections.
What are we measuring and why?
For patients in an intensive care setting, frequent need for intravenous medications, blood, fluid replacement, or nutrition often necessitates a central venous catheter, or central line. Though critical and often life-saving, these central lines can cause serious bloodstream infections. Programs that help us avoid such infections are vital to our ability to deliver high-quality hospital care.
Caused by the bacteria Clostridium difficile, C. difficile infection affects approximately 500,000 Americans each year. Marked by intestinal inflammation and diarrhea, its onset is closely linked with antibiotic use and is more common in hospitals and nursing home settings where the bacteria can flourish. C. difficile can cause serious complications and even death—one in 11 patients age 65+ will die within a month of its diagnosis.
Central Line-Associated Bloodstream Infections
Partners hospitals report data on central line infections in intensive care units (ICU) of all types, including Medical Cardiac, Cardiac Surgery, Thoracic, Medical, Surgical, and Neonatal. Our data is reported separately for each ICU type. By understanding the occurrence of central line infections, our hospitals can take steps to reduce or eliminate them. To make comparisons meaningful, we compare how our hospitals perform with a U.S. national benchmark.
How do we compare to best practice benchmarks?
Across all but one unit, Partners HealthCare hospitals’ ICUs perform better than or the same as the U.S. national benchmark.
| Unit |
Infections |
Line Days |
Rate |
Predicted Infections |
SIR |
Compared to Predicted Infections |
| Medical Cardiac ICU |
4 |
1,949 |
2.05 |
2.199 |
1.819 |
No Different than U.S. National Benchmark |
| Cardiac Surgery ICU |
1 |
3,584 |
0.28 |
4.044 |
0.247 |
No Different than U.S. National Benchmark |
| Thoracic ICU |
2 |
1,770 |
1.13 |
1.997 |
1.001 |
No Different than U.S. National Benchmark |
| Medical ICU |
4 |
3,869 |
1.03 |
4.366 |
0.916 |
No Different than U.S. National Benchmark |
| Surgical ICU |
5 |
2,440 |
2.05 |
2.753 |
1.816 |
No Different than U.S. National Benchmark |
| Neonatal ICU |
0 |
1,766 |
0.00 |
2.689 |
0 |
No Different than U.S. National Benchmark |
Read more details about this measure.
Measure Details
Partners HealthCare Data Period: January 2017 - December 2017
Partners HealthCare Data Source: National Healthcare Safety Network
Our data show how five Partners HealthCare hospitals perform on this metric when compared to the U.S. National Benchmark (the National Healthcare Safety Network).
Ratings:
"Better than U.S. National Benchmark" – The number of central line associated bloodstream infections was significantly less than expected.
"No Different than U.S. National Benchmark" – The number of central line associated bloodstream infections was similar to the number expected.
"Worse than U.S. National Benchmark" – The number of central line associated bloodstream infections was significantly higher than expected.
Standardized Infection Ratio:
The standardized infection ratio (SIR) is a summary measure used to track Health Care-Associated Infections (HAIs) at a national, state, or local level over time. The SIR compares the actual number of HAIs reported with the baseline national experience, adjusting for several risk factors that have been found to be significantly associated with hospital-to-hospital differences in infection incidence. A SIR greater than 1.0 indicates that more HAIs were observed than predicted. A SIR of less than 1.0 indicates that fewer HAIs were observed than predicted.
Predicted Infections:
The predicted rate of infections is based on the average number of infections nationally.
| Unit |
Infections |
Line Days |
Rate |
Predicted Infections |
SIR |
Compared to Predicted Infections |
| Medical/Surgical ICU |
0 |
542 |
0.00 |
0.531 |
. |
* |
* SIR not calculated if Predicted Infections < 1
Read more details about this measure.
Measure Details
Partners HealthCare Data Period: January 2017 - December 2017
Partners HealthCare Data Source: National Healthcare Safety Network
Our data show how five Partners HealthCare hospitals perform on this metric when compared to the U.S. National Benchmark (the National Healthcare Safety Network).
Ratings:
"Better than U.S. National Benchmark" – The number of central line associated bloodstream infections was significantly less than expected.
"No Different than U.S. National Benchmark" – The number of central line associated bloodstream infections was similar to the number expected.
"Worse than U.S. National Benchmark" – The number of central line associated bloodstream infections was significantly higher than expected.
Standardized Infection Ratio:
The standardized infection ratio (SIR) is a summary measure used to track Health Care-Associated Infections (HAIs) at a national, state, or local level over time. The SIR compares the actual number of HAIs reported with the baseline national experience, adjusting for several risk factors that have been found to be significantly associated with hospital-to-hospital differences in infection incidence. A SIR greater than 1.0 indicates that more HAIs were observed than predicted. A SIR of less than 1.0 indicates that fewer HAIs were observed than predicted.
Predicted Infections:
The predicted rate of infections is based on the average number of infections nationally.
| Unit |
Infections |
Line Days |
Rate |
Predicted Infections |
SIR |
Compared to Predicted Infections |
| Burn Critical Care |
7 |
883 |
7.93 |
2.997 |
2.336 |
Worse than U.S. National Benchmark |
| Medical Cardiac ICU |
5 |
4,721 |
1.06 |
5.327 |
0.939 |
No Different than U.S. National Benchmark |
| Surgical Cardiothoracic ICU |
4 |
4,881 |
0.82 |
5.507 |
0.726 |
No Different than U.S. National Benchmark |
| Medical Critical Care |
3 |
4,884 |
0.61 |
5.511 |
0.544 |
No Different than U.S. National Benchmark |
| Pediatric Medical/Surgical ICU |
3 |
1,577 |
1.90 |
2.271 |
1.321 |
No Different than U.S. National Benchmark |
| Neurosurgical ICU |
1 |
3,249 |
0.31 |
3.666 |
0.273 |
No Different than U.S. National Benchmark |
| Surgical Critical Care |
0 |
4,647 |
0.00 |
5.243 |
0 |
Better than U.S. National Benchmark |
| Neonatal Critical Care |
3 |
2,057 |
1.46 |
2.439 |
1.23 |
No Different than U.S. National Benchmark |
Read more details about this measure.
Measure Details
Partners HealthCare Data Period: January 2017 - December 2017
Partners HealthCare Data Source: National Healthcare Safety Network
Our data show how five Partners HealthCare hospitals perform on this metric when compared to the U.S. National Benchmark (the National Healthcare Safety Network).
Ratings:
"Better than U.S. National Benchmark" – The number of central line associated bloodstream infections was significantly less than expected.
"No Different than U.S. National Benchmark" – The number of central line associated bloodstream infections was similar to the number expected.
"Worse than U.S. National Benchmark" – The number of central line associated bloodstream infections was significantly higher than expected.
Standardized Infection Ratio:
The standardized infection ratio (SIR) is a summary measure used to track Health Care-Associated Infections (HAIs) at a national, state, or local level over time. The SIR compares the actual number of HAIs reported with the baseline national experience, adjusting for several risk factors that have been found to be significantly associated with hospital-to-hospital differences in infection incidence. A SIR greater than 1.0 indicates that more HAIs were observed than predicted. A SIR of less than 1.0 indicates that fewer HAIs were observed than predicted.
Predicted Infections:
The predicted rate of infections is based on the average number of infections nationally.
| Unit |
Infections |
Line Days |
Rate |
Predicted Infections |
SIR |
Compared to Predicted Infections |
| Medical/Surgical ICU |
0 |
640 |
0.00 |
0.722 |
. |
* |
* SIR not calculated if Predicted Infections < 1
Read more details about this measure.
Measure Details
Partners HealthCare Data Period: January 2017 - December 2017
Partners HealthCare Data Source: National Healthcare Safety Network
Our data show how five Partners HealthCare hospitals perform on this metric when compared to the U.S. National Benchmark (the National Healthcare Safety Network).
Ratings:
"Better than U.S. National Benchmark" – The number of central line associated bloodstream infections was significantly less than expected.
"No Different than U.S. National Benchmark" – The number of central line associated bloodstream infections was similar to the number expected.
"Worse than U.S. National Benchmark" – The number of central line associated bloodstream infections was significantly higher than expected.
Standardized Infection Ratio:
The standardized infection ratio (SIR) is a summary measure used to track Health Care-Associated Infections (HAIs) at a national, state, or local level over time. The SIR compares the actual number of HAIs reported with the baseline national experience, adjusting for several risk factors that have been found to be significantly associated with hospital-to-hospital differences in infection incidence. A SIR greater than 1.0 indicates that more HAIs were observed than predicted. A SIR of less than 1.0 indicates that fewer HAIs were observed than predicted.
Predicted Infections:
The predicted rate of infections is based on the average number of infections nationally.
| Unit |
Infections |
Line Days |
Rate |
Predicted Infections |
SIR |
Compared to Predicted Infections |
| Surgical Cardiothoracic ICU |
0 |
2,139 |
0.00 |
2.414 |
0 |
No Different than U.S. National Benchmark |
Read more details about this measure.
Measure Details
Partners HealthCare Data Period: January 2017 - December 2017
Partners HealthCare Data Source: National Healthcare Safety Network
Our data show how five Partners HealthCare hospitals perform on this metric when compared to the U.S. National Benchmark (the National Healthcare Safety Network).
Ratings:
"Better than U.S. National Benchmark" – The number of central line associated bloodstream infections was significantly less than expected.
"No Different than U.S. National Benchmark" – The number of central line associated bloodstream infections was similar to the number expected.
"Worse than U.S. National Benchmark" – The number of central line associated bloodstream infections was significantly higher than expected.
Standardized Infection Ratio:
The standardized infection ratio (SIR) is a summary measure used to track Health Care-Associated Infections (HAIs) at a national, state, or local level over time. The SIR compares the actual number of HAIs reported with the baseline national experience, adjusting for several risk factors that have been found to be significantly associated with hospital-to-hospital differences in infection incidence. A SIR greater than 1.0 indicates that more HAIs were observed than predicted. A SIR of less than 1.0 indicates that fewer HAIs were observed than predicted.
Predicted Infections:
The predicted rate of infections is based on the average number of infections nationally.
Clostridium Difficile (C. diff) Infections
Since C. difficile is linked to hospital stays and often develops during a patient’s stay, patients are tested for C. diff. infections if they show signs of illness while in the hospital. This measure compares the number of stool specimens that tested positive for C. diff toxin, four or more days after the patient entered the hospital, to a national benchmark. Different hospitals use different methods to test for C. diff, therefore caution should be used when comparing data between institutions. In addition, all Partners hospitals have recently changed, or are in the process of changing C. diff testing methods. The new methods are more sensitive and as a result C. diff rates may rise.
How do we compare to best practice benchmarks?
Across all five hospitals, Partners performs better than or the same as the U.S. national benchmark.
| Hospital |
Performance
(see second tab above for more detailed information) |
| Brigham and Women's Hospital |
Better than US National Benchmark |
| Brigham and Women's Faulkner Hospital |
No different than US National Benchmark |
| Massachusetts General Hospital |
No different than US National Benchmark |
| Newton-Wellesley Hospital |
No different than US National Benchmark |
| North Shore Medical Center* |
Better than US National Benchmark |
*includes North Shore Salem and North Shore Union Hospitals
Read more details about this measure
Measure Details
Partners HealthCare Data Period: January 2017 - December 2017
Partners HealthCare Data Source: National Healthcare Safety Network
Our data show how five Partners hospitals perform on this metric when compared to the U.S. National Benchmark (the National Healthcare Safety Network).
Ratings:
“Better than US National Benchmark” – The number of hospital-acquired C. diff infections was significantly less than expected.
“No Different than US National Benchmark” – The number of hospital-acquired C. diff infections was similar to the number expected.
“Worse than US National Benchmark” – The number of hospital-acquired C. diff infections was significantly higher than expected.
US National Benchmark SIR = 1
Standardized Infection Ratio:
The standardized infection ratio (SIR) is a summary measure used to track Health Care-Associated Infections (HAIs) at a national, state, or local level over time. The SIR compares the actual number of HAIs reported with the baseline national experience, adjusting for several risk factors that have been found to be significantly associated with hospital-to-hospital differences in infection incidence. A SIR greater than 1.0 indicates that more HAIs were observed than predicted. A SIR of less than 1.0 indicates that fewer HAIs were observed than predicted. However, the SIR alone does not imply statistical significance. Confidence intervals are then used to determine if the SIR is significantly higher or lower than predicted.
Predicted Infections:
The predicted rate of infections is based on the average number of infections nationally.
| Hospital |
# of Infections |
# of Predicted Infections |
Patient Days |
SIR |
Compared to Predicted Infections |
| Brigham and Women's Hospital |
122 |
174.3 |
236,977 |
0.7 |
Better than US National Benchmark |
| Brigham and Women's Faulkner Hospital |
21 |
19.513 |
35,358 |
1.076 |
No different than US National Benchmark |
| Massachusetts General Hospital |
231 |
258.11 |
295,039 |
0.895 |
No different than US National Benchmark |
| Newton-Wellesley Hospital |
34 |
34.435 |
50,017 |
0.987 |
No different than US National Benchmark |
| North Shore Medical Center* |
32 |
45.99 |
69,569 |
0.696 |
Better than US National Benchmark |
*includes North Shore Salem and North Shore Union Hospitals
Read more details about this measure.
Measure Details
Partners HealthCare Data Period: January 2017 - December 2017
Partners HealthCare Data Source: National Healthcare Safety Network
Our data show how five Partners hospitals perform on this metric when compared to the U.S. National Benchmark (the National Healthcare Safety Network).
Ratings:
“Better than US National Benchmark” – The number of hospital-acquired C. diff infections was significantly less than expected.
“No Different than US National Benchmark” – The number of hospital-acquired C. diff infections was similar to the number expected.
“Worse than US National Benchmark” – The number of hospital-acquired C. diff infections was significantly higher than expected.
US National Benchmark SIR = 1
Standardized Infection Ratio:
The standardized infection ratio (SIR) is a summary measure used to track Health Care-Associated Infections (HAIs) at a national, state, or local level over time. The SIR compares the actual number of HAIs reported with the baseline national experience, adjusting for several risk factors that have been found to be significantly associated with hospital-to-hospital differences in infection incidence. A SIR greater than 1.0 indicates that more HAIs were observed than predicted. A SIR of less than 1.0 indicates that fewer HAIs were observed than predicted. However, the SIR alone does not imply statistical significance. Confidence intervals are then used to determine if the SIR is significantly higher or lower than predicted.
Predicted Infections:
The predicted rate of infections is based on the average number of infections nationally.
