1. What is the decision or change (e.g., clinical topic, practice guideline, system design, delivery of care) you are facing or struggling with where a summary of the evidence would be helpful?
The challenge I face is that, in 2008 CMS declared hospital acquired CAUTI to be "mostly preventable" and defunding its reimbursement. CMS expected that action would incentivize hospitals to adopt protocols designed to reduce CAUTI. That did not happen! Instead CAUTI hospitals adapted to the defunding by postponing and prioritizing purchases. In 2018 CMS was vindicated when a novel approach aimed at elimination CAUTI proved that Hospital Acquired CAUTI was indeed mostly preventable. that approach is the subject of this Topic Nomination. The novel approach to CAUTI has proven effective and been shown eliminate 80-90% CAUTI.
2. Why are you struggling with this issue?
Despite clinical evidence to the contrary, many budget committees remain intransigent and skeptical. The patients are caught in the middle and are bearing the brunt of delays of availability of this technology. Despite availability of this novel technology since 2018, as of Jan 2023, only 68 of the more than 4,000 CMS approve hospitals have acquired this healthcare quality improvement. The percentage incident of hospital acquired CAUTI has remained virtually unchanged since 2008. Many reticent hospitals request that an onsite 'clinical trial' be performed before they will commit. Frankly that is impractical. It remains unclear ho to how to incentivize skeptics. An evidence based report from a trusted source such as EHC may be determinant in convincing skeptics to accept reality and adapt the new Stand-of-Care. Health care quality and safety are being ignored.
3. What do you want to see changed? How will you know that your issue is improving or has been addressed?
In the short run an evidence based EHC report should help quiet requests for individual 'mini-clinical trails' and reassure skeptics that CAUTI reduction is achievable. In the longer run, however, in the interest of securing patient safety and access to quality care either the Joint Commission will have to seriously consider conditioning reaccreditation on availability of this technology since it is so closely aligned to AKI prevention (please refer to Topic Nomination #2: A novel approach to AKI Forecast, diagnosis and Prevention which accompanies this Topic Nomination) or CMS will have to codify it in its CoP and CfC.
4. When do you need the evidence report?
Mon, 06/03/2024
5. What will you do with the evidence report?
health care decision makers depend on reliable information sources to help them prioritize their stained budgets. not infrequently hospital purchasers need an endorsement and reassurance from a trusted and reputable source, e.g. EHC. The EHC evidence report will be presented to skeptics to reassure them they are making the correct decision on behalf of their patients and their budget. If voluntary acquisition does not achieve the anticipated reduction in CAUTI incidence then incentivize acquisition via The Joint Commission or CMS may be justified to insure patient care quality and security.
Optional Information About You
What is your role or perspective? Physician
May we contact you if we have questions about your nomination? Yes
