Evaluation of the Plan to Prevent Healthcare-Associated Infections

Official Title
Phase II of a Longitudinal Program Evaluation of HHS HAI NAP
United States
9/2013 – 9/2016
IMPAQ Health
Mixed Method Evaluations
Agency for Healthcare Research and Quality
Sub To
Insight Policy Research
Mixed Methods Research
Survey Design and Sampling

This was the second phase of a now seven-year evaluation, which continued the work IMPAQ and RAND began in 2009. With Insight Policy Research as the lead, we continued to evaluate the longitudinal impact of the US Department Health and Human Services’ (HHS) response to healthcare-associated infections (HAI).

This phase built on the methodology we developed earlier in the project (which focused on acute care hospitals) and expanded the assessment to ambulatory surgical centers, end-stage renal disease facilities, and long-term care facilities. We worked with stewards of clinical surveillance and administrative claims data to identify infections and analyze trends in infection rates. Along with the quantitative and qualitative data collected by Insight and RAND, these trends evaluated the impact of the National Action Plan (NAP) on its goals – to reduce, prevent, and ultimately eliminate health care-associated infections.

We used a mixed-methods approach, combining key informant interviews, a review of programs and projects, and a quantitative analysis of patient safety practice adoption with the infection rate trend analysis. The longitudinal nature of the evaluation meant that data sets continued to evolve as surveillance capacity improves and infection definitions change. Therefore, this analysis had both quantitative and qualitative components. To interpret the rates most effectively, we also conducted literature reviews on infection surveillance and gathered information on changes and limitations from the data stewards.

This was one of IMPAQ’s longest-running evaluations. It has allowed us to develop ongoing relationships with key HHS stakeholders in patient safety and health quality, and our longitudinal HAI data rates analysis has given us deep, working knowledge of a variety of HHS data systems. The team included senior health quality researchers, qualitative and quantitative methodologists, statisticians, and data analysts. Our project director had seven years of experience working on patient safety evaluations.