Paving the Path Forward: 2015 Rebaseline

New! NHSN’s Guide to the SUR (updated October 2018) Cdc-pdf[PDF – 1 MB]

A comprehensive guide to the NHSN’s SUR, including significant factors used in the SUR calculations under the 2015 baseline.

New! NHSN’s Guide to the SIR (updated March 2019) Cdc-pdf[PDF – 2 MB]

A comprehensive guide to NHSN’s SIR, including risk factors used in the SIR calculations under the 2015 baseline.

Frequently asked questions about definition changes, the SIR, and the 2015 rebaseline

NHSN collects and analyzes healthcare-associated infections (HAI) data reported from across the nation to help track HAI incidence, identify opportunities to eliminate HAIs, and measure the progress of HAI prevention efforts. Progress is measured using a summary statistic called the standardized infection ratio (SIR). This comparative metric is calculated after risk adjusting the data reported into NHSN. State and national progress is presented each year in CDC’s HAI Progress Report. In this report, the SIRs are adjusted for risk factors that can impact the number of infections reported by a hospital, such as type of patient care location, bed size of the hospital, patient age, and other factors.

Healthcare facilities may report the following HAI types into NHSN:

  • Central line-associated bloodstream infections (CLABSIs)
  • Catheter-associated urinary tract infections (CAUTIs)
  • Surgical site infections (SSIs)
  • Hospital-onset Clostridioides difficile (C. difficile)
  • Hospital-onset methicillin-resistant Staphylococcus aureus (MRSA) bacteremia (bloodstream infections)

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What is a baseline?

CDC uses reported HAI data to calculate the SIR for each reporting state and facility. The SIR compares the number of infections in a facility or state to the number of infections that were “predicted”, or would be expected, to have occurred based on previous years of reported data (i.e., baseline data). The number of predicted infections is an estimate based on aggregated data reported to CDC’s NHSN during a specific baseline period. The current risk adjustment methods and baseline periods vary by HAI type and/or healthcare facility type.

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What is the 2015 Rebaseline?

“Rebaseline” is a term that CDC’s National Healthcare Safety Network (NHSN) staff is using to describe updates to original HAI baselines. The 2015 rebaseline updates both the source of aggregate data and the risk adjustment methodology used to create the original baselines. Risk adjustment refers to the processes used to account for the differences in risk that may impact the number of infections reported by a hospital, such as type of patient care location, bed size of the hospital or patient age. When the data are risk-adjusted, it makes it possible to fairly compare hospital performance. In this report, the SIRs are adjusted for risk factors.

Previously calculated SIRs had different baseline years for each infection type and facility type. Beginning with 2015 data, HAI prevention progress will be measured in comparison to infection data reported to NHSN using updated risk-adjustment models. SIRs using the 2015 baselines will be available in NHSN on January 7, 2017.

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Original National Baseline Data
HAI Type Original National Baseline Data 2015 Rebaseline
Acute Care Hospitals (ACH) Long-term Acute Care Hospitals (LTACH) Inpatient Rehabilitation Facilities (IRF)
CLABSIs 2006-2008 2013 2013 2015
CAUTIs 2009 2013 2013 2015
SSIs 2006-2008 None None 2015
(ACH only)
Hospital-onset C. difficile 2010-2011 None None 2015
Hospital-onset MRSA bacteremia 2010-2011 None None 2015
Ventilator-associated events (VAE) New – No Previous National Baseline Data 2015
Mucosal Barrier Injury (MBI) 2015
Standardized Utilization Ratio (SUR) (all device types) 2015

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What can hospitals and other organizations expect to happen to their SIRs after the 2015 rebaseline?

The data included in the 2015 baseline will serve as a new “reference point” for comparing progress. CDC expects that hospital SIRs will increase and shift closer to 1, especially for SIRs that will be calculated for 2015.

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Rebaseline FAQs

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CMS Related Resources

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Other Resources

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