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The Hidden Secret of C. diff and the HAC Penalty

By Stacy Sutton

Do you know your HAC score? Is your hospital on the HAC list? If not, do you think you are safe?

Think again. Unless your Hospital-Acquired Condition score is below 3, your facility is likely one outbreak away from getting on the HAC list. Take a look at the histogram below, which represents CMS data from all hospitals in the U.S. Most hospitals have a HAC score that’s clustered in a tight group between 3.5 and 8. Scores above 6.5 are on the HAC list, while scores below 6.5 are not.

The Hidden Secret of C. diff and the HAC Penalty

What this clustering tells us is that small changes to patient outcomes can have a large impact on where your hospital sits relative to this line. Essentially, small movements in infections can have a big impact on whether you get on or off the list.

Reducing HAIs takes a substantial organizational commitment, but in almost every hospital, resources dedicated to infection control are very limited. So where do you start?

Clostridium difficile!

Most people know that C. diff now accounts for 20% of the overall HAC score. If we dig a bit deeper, we can see that small changes in C. diff can account for major swings in your HAC score.

The graph below shows all the major infection types versus the HAC score. Not surprisingly, as the HAC score goes up, so do the infections. Most infections have a linear increase, except C. diff!


HAC List

Look at the red line – it doesn’t quite follow the same pattern. The rate of C. diff infections is not linear and is flatter, especially between 3.5 and 8. So what does this mean?

This flattening tells us that small changes to your C. diff score can result in a big swing in your HAC score. When you combine this with C. diff making up 20% of the overall HAC score, you quickly see that this is where your resources are best focused.

At Clean Hands – Safe Hands, we leverage our electronic hand hygiene performance system to specifically address C. diff.

In addition, our system is the only one on the market with an Adaptive Room Mode™ specifically for C. diff patients. While our Natural Language Voice Reminder™ reminds clinicians in regular rooms to “Please sanitize,” the voice in C. diff rooms can, with the click of a button, instead say “Soap and water only.” This helps reduce the spread of C. diff, improves CDI and HAC scores, and can potentially keep your hospital off the HAC list.

A recent customer decreased C. diff by 74% in just 6 months. Two other hospitals reduced C. diff by 80% across two facilities, representing a net savings greater than $1 million per facility. And that $2 million total doesn’t even include a reduction in HAC penalties. Moving off of this list not only means full CMS reimbursements and a healthier bottom line for your hospital, but potentially an improved reputation and patient satisfaction to boot.

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