But I have to stay true to the name of this blog, so for the sake of argument I will now assume a highly impolite and cynical stance regarding this report. Here goes: I don’t believe it.
I think we have reason to assume that a healthy proportion of CLABSIs are “adjudicated away” by many centers, and lord only knows how many other HAIs (VAP, anyone?) vanish into the ether of consensus review, clinician veto, administrative adjustment, or just plain old bad surveillance. Recall also the SHEA 2011 presentation reporting evidence for gaming in the earlier PA data (using methods that can also be criticized, but the “difference-in-differences” analysis was persuasive enough for me to accept that there was both a real reduction in HAI rates, and evidence for gaming, since the PA public reporting mandate).
Now that I’ve thrown down the gauntlet, Pennsylvania, please convince me that these data are accurate. The report references validation—how was it done? Was your own hospital subject to audit of HAI rates? How many records were reviewed, if chart review was performed? What were the credentials of the auditors? As a “consumer” of health care, would you base your decisions about where to receive care on facility level data from your state reporting program?