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Infection Control Measure Performance in Long-Term Care Hospitals and Their Relationship to Joint Commission
Joint Commission Journal on Quality and Patient Safety
|March 16, 2024
Summary
Joint Commission accreditation is associated with lower rates of central line-associated bloodstream infections (CLABSI) and catheter-associated urinary tract infections (CAUTI) in long-term care hospitals. Accredited facilities also demonstrated more consistent high performance in infection control over time.
Area of Science:
- Healthcare Quality
- Infection Prevention
- Hospital Accreditation
Background:
- Health care-associated infections (HAIs) pose a significant challenge in long-term care hospitals (LTCHs).
- The role of accreditation bodies, such as The Joint Commission, in mitigating HAIs is an area of ongoing research.
- Understanding the impact of accreditation on specific HAI types is crucial for improving patient safety.
Purpose of the Study:
- To evaluate the association between Joint Commission accreditation and the incidence of HAIs in LTCHs.
- To compare infection rates, specifically for catheter-associated urinary tract infections (CAUTIs), Clostridioides difficile infections (CDIs), and central line-associated bloodstream infections (CLABSIs), between accredited and non-accredited LTCHs.
- To analyze trends in HAI measures over a four-year period in relation to accreditation status.
Main Methods:
- An observational study utilizing Centers for Medicare & Medicaid Services (CMS) LTCH data from 2017 to June 2021.
- Standardized Infection Ratios (SIRs) for CAUTIs, CDIs, and CLABSIs were analyzed using a random coefficient Poisson regression model.
- Data excluded the period of January to June 2020 due to the COVID-19 pandemic.
Main Results:
- Joint Commission-accredited LTCHs showed significantly lower SIRs for CLABSI and CAUTI compared to non-accredited facilities.
- No significant difference in SIRs was observed for Clostridioides difficile infections (CDIs).
- Accredited LTCHs consistently outperformed the national benchmark for all three HAI measures throughout the study period.
Conclusions:
- Joint Commission accreditation is positively associated with reduced CLABSI and CAUTI rates in LTCHs.
- Accredited LTCHs exhibit more sustained high performance in infection control measures.
- Joint Commission standards focusing on infection control and prevention likely contribute to these improved outcomes.
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