Do Experts Understand Performance Measures? A Mixed-Methods Study of Infection Preventionists

Area of Science:

• Healthcare epidemiology
• Infection prevention and control
• Quality improvement science

Background:

• Central line-associated bloodstream infection (CLABSI) significantly impacts patient morbidity and mortality.
• Despite a national decrease in CLABSI rates, hospital-specific prevention success varies.
• Challenges in interpreting complex CLABSI metrics may hinder consistent prevention efforts.

Purpose of the Study:

• To evaluate expert interpretation of central line-associated bloodstream infection (CLABSI) quality data.
• To identify potential barriers in understanding and applying CLABSI metrics among healthcare professionals.

Main Methods:

• A cross-sectional survey was administered to members of the Society for Healthcare Epidemiology of America (SHEA) Research Network (SRN).
• A 10-item test assessed comprehension of CLABSI data, with performance measured by the percentage of correct answers.
• Experts also provided perceptions of CLABSI reporting reliability.

Main Results:

• The average expert performance was 73% correct, with significantly better scores on unadjusted data (86%) compared to risk-adjusted data (65%).
• Experts rated the reliability of CLABSI data as 61 out of 100.
• Lower perceived reliability correlated with better data interpretation, indicating a complex relationship between perception and performance.

Conclusions:

• Substantial variability exists among experts in interpreting CLABSI data, particularly risk-adjusted metrics.
• The complexity of CLABSI data, especially risk adjustment, presents a barrier to consistent application.
• Enhancements in data sharing and public policy are needed to address the complexities of CLABSI metric interpretation and application.