Ensuring rational public reporting systems for health care–associated infections: Systematic literature review and evaluation recommendations

Background The Centers for Disease Control and Prevention (CDC) systematically reviewed published studies for the Healthcare Infection Control Practices Advisory Committee (HICPAC) in preparation for guidance to states on mandatory public reporting systems for health care–associated infections (HAI) in hospitals. The HICPAC asked whether public reporting systems are effective in improving health care performance, by measured improvements in clinical processes or patientsʹ health status as the intended outcomes, including but not limited to reduced HAI events; and whether new evidence of effectiveness of private reporting policies to reduce HAI had been published since the 1970s landmark Study on the Efficacy of Nosocomial Infection Control study. Methods Public reporting systems are information provided to the public about the quality of health services. Of 450 published papers reviewed using specific inclusion and exclusion criteria, 10 studies qualified for detailed, protocol-based abstractions. Results Findings indicate that the evidence for effectiveness for public reporting systems to improve health care performance is inconclusive. No studies have investigated reduction of HAI as an outcome of public reporting. Conclusion Rigorous evaluation of mandatory public reporting systems for HAI is recommended to ensure that stakeholdersʹ needs are identified and met.