1235. A Survey of Surgical Site Infection (SSI) Surveillance Practices in US Hospitals, and their Association with SSI Rates

BACKGROUND: Current US hospital reimbursement models rely on self-reported SSI rates. The impact of variability in SSI surveillance on publicly reported SSI rates is unknown. METHODS: Cross-sectional survey to US hospitals administered during November 18 – 2/19 through the Association for Professionals in Infection Control. We assessed SSI surveillance practices, and asked for self-reported facility standardized infection ratios (SIR) for hysterectomy and colon surgeries. We performed bivariate analysis and used Kendall’s ranks correlation for trend analysis. RESULTS: Of the 2,851 hospitals surveyed, 491 (17.2%) responded. Table 1 shows facility descriptors. Critical Access Hospitals (OR 6.11 [3.12 – 11.750, P < 0.005) and Ambulatory Surgical Centers (OR 3.92 [1.68 – 8.64], P < 0.001) were more likely to have less than one full-time ICP. University Hospitals were more likely to have ≥4 ICPs (OR 12.15 [6.73 – 22.04, P < 0.001). The majority (83%) of the 477 respondents reported electronic software for SSI surveillance, with Epic (23%), Theradoc (22%), and Cerner (11%) as the most common packages used. Manual surveillance was more likely for Critical Access Hospitals (OR 2.80 [1.47 – 5.19], P < 0.001). University Hospitals were more likely to have higher rates in 2016 for colon surgery (P = 0.02) and hysterectomy (P = 0.002). Table 2 shows characteristics of SSI surveillance practices reported by study participants. Ambulatory Surgical Center ICPs were more likely to use reports from surgeons and/or surgical staff as the initial trigger for SSI surveillance. University Hospital ICPs were significantly more likely to spend increased time (mean hours/month 69.77 vs. 28.99, P < 0.001), and to use more data sources for SSI review (mean 4.58 vs. 3.99, P = 0.001). In our trend analyses, we found the number of data sources used for SSI surveillance to be positively associated with higher SSI rates: (K(T) =0.14, P = 0.028 for colon SIR in 2017; K(T) = 0.20, P = 0.009; K(T) = 0.25, P = 0.001 for hysterectomy SIR in 2016 and 2017, respectively). CONCLUSION: SSI surveillance practices across US hospitals vary significantly, and rigorous surveillance methods are associated with higher SSI rates. Standardizing SSI surveillance is necessary to accurately capture SSI burden of disease. [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures.