• Valerie B Haley, Carole Van Antwerpen, Boldtsetseg Tserenpuntsag, Kathleen A Gase, Peggy Hazamy, Diana Doughty, Marie Tsivitis, and Rachel L Stricof.
• New York State Department of Health, Bureau of Healthcare Associated Infections, Albany, NY 12237, USA. vbh03@health.state.ny.us
• Infect Control Hosp Epidemiol. 2012 Jun 1;33(6):565-71.

ObjectiveTo efficiently validate the accuracy of surgical site infection (SSI) data reported to the National Healthcare Safety Network (NHSN) by New York State (NYS) hospitals.DesignValidation study.Setting176 NYS hospitals.MethodsNYS Department of Health staff validated the data reported to NHSN by review of a stratified sample of medical records from each hospital. The four strata were (1) SSIs reported to NHSN; (2) records with an indication of infection from diagnosis codes in administrative data but not reported to NHSN as SSIs; (3) records with discordant procedure codes in NHSN and state data sets; (4) records not in the other three strata.ResultsA total of 7,059 surgical charts (6% of the procedures reported by hospitals) were reviewed. In stratum 1, 7% of reported SSIs did not meet the criteria for inclusion in NHSN and were subsequently removed. In stratum 2, 24% of records indicated missed SSIs not reported to NHSN, whereas in strata 3 and 4, only 1% of records indicated missed SSIs; these SSIs were subsequently added to NHSN. Also, in stratum 3, 75% of records were not coded for the correct NHSN procedure. Errors were highest for colon data; the NYS colon SSI rate increased by 7.5% as a result of hospital audits.ConclusionsAudits are vital for ensuring the accuracy of hospital-acquired infection (HAI) data so that hospital HAI rates can be fairly compared. Use of administrative data increased the efficiency of identifying problems in hospitals' SSI surveillance that caused SSIs to be unreported and caused errors in denominator data.

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