HHS Action Needed to Obtain Nationally Representative Data on Risks in Ambulatory Surgical Centers

Disparate sources of data on HAIs in ASCs are available, but none provide information on the extent of the problem nationwide. Such data are useful for guiding federal policies aimed at preventing the lapses in infection control practices—such as reusing syringes and drawing medication to be injected into multiple patients from single-dose vials—that can lead to increased risk of HAIs for patients. GAO identified five data sources—two operated by HHS, two by professional organizations, and one by a state government—all of which differ from one another in the type of HAI information they collect. In order to make nationwide estimates of HAIs and lapses in related infection control practices in ASCs, a data source would need to collect its data from a nationally representative random sample of ASCs. However, none of the five sources does so. The two professional organizations and the state source collect data from narrowly defined subsets of ASCs. The most detailed data are provided by the two federal sources, one of which collects outcome data and the other process data. Experts GAO interviewed said it was more feasible for ASCs to collect process data than outcome data. The Centers for Disease Control and Prevention’s (CDC) National Healthcare Safety Network collects detailed, standardized data on HAI outcomes that are comparable across hospitals and other health care facilities, but it has only recently begun to collect data on ASCs and it is not set up to collect nationally representative data. The other HHS data source, a CMS ASC pilot study conducted in three states, collects detailed process data on practices that affect the risk of HAIs. What GAO Recommends To collect nationally representative and standardized information on ASC compliance with infection control practices that reduce HAIs, GAO recommends that the Acting Secretary of HHS develop and implement a written plan to use the data collection instrument and methodology tested in the ASC pilot to conduct recurring periodic surveys of randomly selected ASCs. In response, CMS concurred with the recommendation.