Clostridium Difficile Infection (CDI)

Identifying Attributes

Care Settings
Hospital Care
Country
United States of America
Publishing Organisation
Centers for Medicare & Medicaid Services (CMS): Hospital-Acquired Condition (HAC) Reduction Program, Centers for Medicare & Medicaid Services (CMS): Hospital Value-Based Purchasing (VBP) Program, The Leapfrog Group
Type of Quality Indicator
Outcome
IOM Quality Dimension
Safety
Domain
Infection and Sepsis

Defining Attributes

Definition

Standardised infection ratio (SIR) and Adjusted Ranking Metric (ARM) of hospital-onset CDI Laboratory-identified events (LabID events) among all inpatients in the facility.

Numerator

Total number of observed hospital-onset incident CDI LabID events among all inpatients in the facility.

Denominator

Total number of predicted hospital-onset CDI LabID events, calculated using the facility's number of inpatient days, facility type, CDI event reporting from Emergency Department and 24 hour observation units, bed size, ICU bed size, affiliation with medical school, microbiological test method used to identify C. difficile, and community-onset CDI admission prevalence rate.

Exclusions

Data from patients who are not assigned to an inpatient bed are excluded from the denominator counts, including outpatient clinics, 24-hour observation units, and emergency department visits. Inpatient rehab locations and inpatient psychiatric locations that have their own Centers for Medicare and Medicaid Services (CMS) Certification Number (CCN) are excluded. Additionally, data from NICU, SCN, babies in LDRP, well-baby nurseries, or well-baby clinics are excluded from the denominator count.

Use of Risk Adjustment
Yes
Risk Adjustments

See denominator for risk adjustment details.

Stratifications

By hospital and state.

Collection and Reporting Attributes

Type of Data Collection
Electronic/paper chart records
Data Collection Methods

Hospital information submitted to the National Healthcare Safety Network (NHSN)

Frequency of Data Collection
Quarterly
Frequency of Data Collection in Days
91
Reporting Methods

HAC Reduction Program data is displayed at data.cms.gov

Reporting Frequency
Annually
Reporting Frequency in Days
365
Indicator Has Recommended Targets
No

Source and Reference Attributes

Technical Specifications
Link to Measurement Tools
Quality Indicator Confirmed to be Part of a Program Used to Monitor Quality and Safety of Care Among Older People at a Population-Level between 2012-2022
Yes
Assessed by the Australian Consortium for Aged Care Collaborators as Generally Containing Good Properties (Importance and Scientific Acceptability)
Yes
Australian Consortium for Aged Care Endorsed
Yes
Can the Quality Indicator be Readily Implemented at a Population Level in Australia Given its Current Data Landscape?
No. Some data exists in a program or registry, but there is insufficient coverage.
Identified by PHARMA-Care Project
No
Upload Date
31 March 2026