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Related Experiment Videos

Practical risk-adjusted quality control charts for infection control.

T L Gustafson1

  • 1Infection Control and Prevention Analysts, Inc, Austin, TX 78735, USA.

American Journal of Infection Control
|December 15, 2000
PubMed
Summary

The Standardized Infection Ratio (SIR) improves infection control by providing risk-adjusted data, outperforming traditional charts. This makes control charts more practical for monitoring healthcare-associated infections.

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Area of Science:

  • Healthcare quality improvement
  • Infection control surveillance
  • Statistical process control

Background:

  • Traditional control charts (P, U) have limitations in healthcare settings, particularly with small denominators and lack of risk adjustment.
  • The Standardized Infection Ratio (SIR) addresses these limitations by incorporating risk adjustment and increasing effective denominators.
  • Effective monitoring of healthcare-associated infections (HAIs) is crucial for patient safety and quality improvement.

Purpose of the Study:

  • To evaluate the performance of various control charts in monitoring healthcare-associated infections.
  • To compare unadjusted and risk-adjusted control charts using the Standardized Infection Ratio (SIR).
  • To identify optimal statistical techniques for practical infection control surveillance.

Main Methods:

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  • Utilized data from the AICE National Database Initiative, including risk-stratified infection data from US hospitals.
  • Constructed run charts and compared the performance of 5 unadjusted and 11 risk-adjusted control charts.
  • Assessed chart performance using a gold standard of manually categorized flagged points from traditional hypothesis tests.

Main Results:

  • Unadjusted control charts (C, P, U) demonstrated poor sensitivity and specificity.
  • Risk-adjusted control charts, particularly the mXmR chart utilizing the SIR, showed significantly improved performance.
  • The mXmR chart achieved >80% sensitivity and specificity with a receiver operating characteristic area of 0.84.

Conclusions:

  • The Standardized Infection Ratio (SIR) is a valuable statistic for enhancing control chart utility in infection control.
  • Specific control chart techniques, like the mXmR chart, can make surveillance more practical and effective.
  • These findings support the adoption of risk-adjusted control charts for improved monitoring of healthcare-associated infections.