APIC: Data Reporting Burden Hobbles Infection Preventionists

The average amount of time infection preventionists spend reporting hospital infection data to federal health agencies outweighs time spent on staff and patient education, policy development, and other infection-fighting tasks, researchers find.

At the expense of activities that might directly avert the spread of disease, infection preventionists spend more than half their time collecting and reporting hospital infection data, research shows.

Five hours a day is the average amount of time spent collecting and reporting hospital infection data to federal health agencies, according to a study to be released Saturday at the APIC (Association for Professionals in Infection Control and Epidemiology) conference in Nashville.

"We always knew reporting data took a long time," says Sharon Parrillo, assistant director of infection prevention at Robert Wood Johnson University Hospital Somerset in Somerville, NJ, lead author of a published in the June issue of the American Journal of Infection Control.

But it wasn't until Parrillo looked at the fine print of a government reporting form and noticed the amount of time a government agency estimated a specific reporting task should take that she realized how much extra time was actually being consumed by data-related tasks.

So she begin tallying the amount of time it took to perform each function associated with the collection and reporting of data in her 355-bed hospital.

The time spent on tasks associated with reporting NHSN data during a period in which the hospital was at approximately 60% capacity— five hours and eight minutes—did not include time spent reporting to state or local agencies.

"We knew we were spending a lot of time on it, but to put a calculation on it and see it on paper was very eye opening," says Parrillo.

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She believes the data is important, but wishes her team members had more time to dedicate to other tasks, such as "environmental rounding, staff and patient education, policy development, evidence-based research, hand hygiene enforcement, and emergency preparedness."

Infection prevention teams are typically small and strapped for time, even without the additional responsibilities of reporting, she says. "These findings are not a surprise to any of us who are working in the infection prevention field. If you talk to any practitioner, they will tell you they spend most of their day on mandatory reporting."

Parrillo says that collecting and reporting device-denominator data—data that shows which devices are in use and by which patients—took 160 hours total during the four months of the study. And her hospital's EHR does not automatically configure this data for reporting or report it to agencies.

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That infection preventionists spend more than five hours per day on reporting doesn't sound like an exaggeration to William Bria, MD, executive vice president of medical informatics and patient safety at CHIME, the College of Healthcare Management Executives.

He contends that improved data governance and database structuring would help ease the workload. Parrillo's EHR notwithstanding, Bria believes that most EHRs do have the capability to automatically compile or report data to federal agencies, and that infection prevention teams should be taking advantage of it.

Better organization of data and standardization of databases are key to streamlining the process and to improving efficiency, he says. "Four [or] five hours for a report for a very large data set would be very contingent upon the structure of the database."

Other steps that might cut reporting time include using pre-selected "pick-lists," automating reporting so the data is pulled overnight and sent automatically, and making sure that the data is entered into the system uniformly and in an organized fashion.

But Bria recognizes that these things are easier said than done, and empathizes with infection preventionists. "Trying to retroactively fix very messy, poorly structured data is never a good use of anybody's time…. The idea that they should just 'suck it up' is very dismissive to the difficult jobs of infection control staff… We need to focus on analytics that matter."

Parrillo hopes federal agencies and hospital leadership develop a greater appreciation for the difficulty of her role. "This data is not unimportant; it can help protect patients at the bedside. But I hope to shine a light on how our departments are staffed… to make sure we're being supported in a way that makes sense. Hospitals across the country should reevaluate their [infection prevention] programs and make sure they have enough staff."