*RAND Corporation, Santa Monica †David Geffen School of Medicine at UCLA, Los Angeles, CA ‡IMPAQ International, LLC, Columbia, MD.
Med Care. 2014 Feb;52(2 Suppl 1):S25-32. doi: 10.1097/MLR.0000000000000031.
Historically, the ability to accurately track healthcare-associated infections (HAIs) was hindered due to a lack of coordination among data sources and shortcomings in individual data sources.
This paper presents the results of the evaluation of the HAI data and the monitoring component of the Action Plan, focusing on context (goals), inputs, and processes.
We used the Content-Input-Process-Product framework, together with the HAI prevention system framework, to describe the transformative processes associated with data and monitoring efforts.
Six HAI priority conditions in the 2009 Action Plan created a focus for the selection of goals and activities. Key Action Plan decisions included a phased-in data and monitoring approach, commitment to linking the selection of priority HAIs to highly visible national 5-year prevention targets, and the development of a comprehensive HAI database inventory. Remaining challenges relate to data validation, resources, and the opportunity to integrate electronic health and laboratory records with other provider data systems.
The Action Plan's data and monitoring program has developed a sound infrastructure that builds upon technological advances and embodies a firm commitment to prioritization, coordination and alignment, accountability and incentives, stakeholder engagement, and an awareness of the need for predictable resources. With time, and adequate resources, it is likely that the investment in data-related infrastructure during the Action Plan's initial years will reap great rewards.
由于数据源之间缺乏协调以及单个数据源存在缺陷，历史上，准确跟踪医疗保健相关感染（HAI）的能力受到阻碍。
本文介绍了 HAI 数据和行动计划监测部分的评估结果，重点关注背景（目标）、投入和流程。
我们使用了内容-输入-过程-产品框架，以及 HAI 预防系统框架，来描述与数据和监测工作相关的变革过程。
2009 年行动计划中的六项 HAI 优先条件为目标和活动的选择提供了重点。关键的行动计划决策包括逐步实施数据和监测方法、承诺将优先 HAI 的选择与具有高度可见性的国家 5 年预防目标联系起来，以及开发全面的 HAI 数据库清单。遗留的挑战涉及数据验证、资源以及将电子健康和实验室记录与其他提供者数据系统集成的机会。
行动计划的数据和监测计划已经建立了一个健全的基础设施，该基础设施建立在技术进步的基础上，并体现了对优先级、协调和一致性、问责制和激励措施、利益相关者参与以及对可预测资源的需求的坚定承诺。随着时间的推移和充足的资源，行动计划最初几年在数据相关基础设施方面的投资很可能会获得丰厚的回报。
