We realize that you can have a great program in your hospital, but if you are in a community with other providers who aren't doing well, like a nursing home or a long-term acute care hospital, you're going to get these people with C. diff coming to your facility.
So we need better regional approaches in which the health departments, in collaboration with quality improvement organizations (QIOs) and other partners have access to the data, and can look not just at how one hospital is doing, but how various healthcare settings work together to prevent these events.
HLM:That's interesting, because if there's a complication requiring a hospital admission, it wouldn't be counted as a hospital readmission.
Cardo:We're trying to capture that information to provide feedback to the ambulatory center where the procedure was done. We're working on that.
HLM:Are you considering a new kind of database that would collect information from the patient's perspective?
Cardo:This is an interesting idea, but I don't think we're there yet. I'm not saying in the future it's not possible. Because we're always open to whatever is needed to really move the needle.
HLM:The CDC is the investigating agency that takes over when there's a serious outbreak or healthcare problem. And hospitals and physicians don't welcome that. Do you think they're more receptive to your intervention, for example, since the 2012 case of the compounding pharmacy contamination?
Cardo: We don't go if we're not invited. And I don't think we have that problem, especially when local health departments are involved. But they are calling us more and earlier. They know it's better not to have something in the press say, "They didn't call the CDC."
We're working more with CMS to prepare inspectors who investigate complaints about healthcare quality, so they know what to look for and can have an impact. And I think that's happening.
That inspection process is changing, and we have calls with CMS leadership every other week. I have to say that's a process that's much better than it was many years ago, when we weren't even talking.