Hospital-Acquired Complications: A Comparison of Surveillance and Coding Data
Jaimie Yamada1, Shirley Leong1, Andrew Stewardson1, Pauline Bass1, Denise Del Rosario-Kelly1, , 1Alfred Health, Melbourne, Victoria, Australia
Background
The Australian Commission on Safety and Quality in Healthcare lists 16 high-priority hospital-acquired complications (HACs) that are identified by coding data. In the hospital-acquired infections category, pneumonia and urinary tract infections (UTIs) are among the most common complications. The increasing use of International Classification of Diseases (ICD) coding data as a measure of quality care requires a comprehensive understanding of its sensitivity, specificity and risk adjustment adequacy in identifying HACs. The positive predictive value (PPV) of HAC detection through ICD coding data versus traditional surveillance data is undergoing evaluation at Alfred Health, with a focus on pneumonia and UTIs.
Method
We conducted a retrospective analysis using data from Alfred Health. HACs were analysed using ICD coding data and gold standard definitions from the European Centre for Disease Prevention and Control. The ICD coding data, extracted from electronic health records, was linked to specific HAC codes. Traditional surveillance involved manual record review of clinical documentation by a dedicated Infection Prevention (IP) nurse. The PPV of the HAC algorithm was determined through a comparison with IP surveillance results.
Results
The project is ongoing until June 2023, with efforts focused on collating and comparing HAC data, clarifying established definitions of pneumonia and UTI, and developing an electronic tool to streamline case reviews.
Conclusion
The findings will validate the accuracy of coding data to identify healthcare-associated infections. Results will assist in identifying areas with high infection rates defined by surveillance definitions and guide the development of targeted practice interventions to strengthen IP practices.
Biography
Jaimie is an Infection Prevention Nurse Consultant at Alfred Health in Melbourne. She is a recent Master of Public Health graduate from Monash University, with key professional interests in the areas of MRO transmission, HAIs and quality improvement and safety within healthcare organisations.