Pronovost on accountability

Peter Pronovost has a commentary in JAMA this week that is worth a read. Check out the whole thing, I'll post only one small paragraph here:

So who is accountable for reducing CLABSIs? Clinicians inserting and maintaining catheters must be accountable for performance, complying with evidence-based practices. Hospital leaders must be accountable for infection rates, monitoring rates, and supporting prevention initiatives. These mechanisms must be supplemented with the public reporting of valid infection rates, financial incentives from insurers, and when needed, sanctions from regulators. This pandemic of infections can be remedied and prevention of other types of preventable harm can be attempted if clinicians—physicians and nurses—work as a team.

My only comment: public reporting of valid infection rates...is much easier said than done, as we've discussed at length in prior blog posts. Meanwhile, the overzealous pursuit of zero perpetuates the daily battles being waged in some centers between infection preventionists (who are "calling" CLABSIs) and ICU clinicians and administrators (who are challenging these calls).