HHS spent $19M on a 4-year initiative to reduce hospital-acquired infections

Contract Overview

Contract Amount: $19,003,529 ($19.0M)

Contractor: Health Research and Educational Trust

Awarding Agency: Department of Health and Human Services

Start Date: 2011-08-15

End Date: 2015-08-14

Contract Duration: 1,460 days

Daily Burn Rate: $13.0K/day

Competition Type: FULL AND OPEN COMPETITION

Number of Offers Received: 29

Pricing Type: FIRM FIXED PRICE

Sector: Healthcare

Official Description: NATIONAL IMPLEMENTATION OF COMPREHENSIVE UNIT-BASED SAFETY PROGRAM (CUSP) TO REDUCE CATHETER-ASSOCIATED URINARY TRACT INFECTION (CAUTI)

Place of Performance

Location: CHICAGO, COOK County, ILLINOIS, 60606

State: Illinois Government Spending

Plain-Language Summary

Department of Health and Human Services obligated $19.0 million to HEALTH RESEARCH AND EDUCATIONAL TRUST for work described as: NATIONAL IMPLEMENTATION OF COMPREHENSIVE UNIT-BASED SAFETY PROGRAM (CUSP) TO REDUCE CATHETER-ASSOCIATED URINARY TRACT INFECTION (CAUTI) Key points: 1. The contract focused on implementing a safety program to reduce catheter-associated urinary tract infections (CAUTI). 2. The initiative aimed to improve patient safety and reduce healthcare-associated costs. 3. The contract was awarded through full and open competition, suggesting a competitive bidding process. 4. The fixed-price contract type indicates a defined scope and budget, potentially mitigating cost overruns. 5. The duration of the contract was four years, allowing for sustained implementation and evaluation. 6. The project was managed by the Agency for Healthcare Research and Quality (AHRQ).

Value Assessment

Rating: good

The total award of approximately $19 million over four years for a national implementation of a patient safety program appears reasonable given the scope. Benchmarking against similar large-scale health services research and implementation contracts suggests this falls within expected ranges for programs aiming for widespread adoption and impact across healthcare facilities. The firm fixed-price structure provides cost certainty for the government.

Cost Per Unit: N/A

Competition Analysis

Competition Level: full-and-open

This contract was awarded through full and open competition, indicating that all responsible sources were permitted to submit a bid. The presence of 29 bids suggests a robust level of interest and competition for this research and development opportunity. This broad competition is generally favorable for price discovery and ensuring the government receives competitive offers.

Taxpayer Impact: The extensive competition likely resulted in a more favorable price for taxpayers compared to a sole-source or limited competition award. It also suggests that multiple qualified entities were capable of performing this work, providing assurance of a strong vendor pool.

Public Impact

The primary beneficiaries are patients in healthcare facilities across the nation who are at risk of catheter-associated urinary tract infections. The services delivered include the implementation and evaluation of a comprehensive unit-based safety program (CUSP). The geographic impact is national, aiming for widespread adoption of best practices in hospitals and healthcare settings. The initiative has implications for healthcare professionals, including nurses and physicians, by providing tools and training to improve patient care. The ultimate goal is to reduce the incidence of CAUTI, leading to improved patient outcomes and potentially lower healthcare expenditures.

Waste & Efficiency Indicators

Waste Risk Score: 50 / 10

Warning Flags

Ensuring consistent implementation fidelity across diverse healthcare settings can be challenging.
Measuring the direct impact of the program on infection rates requires robust data collection and analysis.
Sustaining the gains achieved after the contract period may require ongoing institutional commitment.

Positive Signals

The contract focuses on a well-defined and evidence-based intervention (CUSP) with a clear objective.
The national scope allows for broad dissemination of best practices and potential for significant public health impact.
The firm fixed-price contract provides budget certainty.
The high number of bids indicates strong market interest and potential for high-quality service delivery.

Sector Analysis

This contract falls within the Research and Development in the Social Sciences and Humanities sector, specifically focusing on healthcare services research and implementation science. The market for health services research and quality improvement initiatives is substantial, driven by government initiatives and private sector efforts to enhance patient care and reduce costs. Comparable spending benchmarks would include other large-scale federal grants and contracts aimed at disseminating clinical best practices or implementing new healthcare delivery models.

Small Business Impact

The data does not indicate any specific small business set-aside provisions for this contract. Given the nature of large-scale national implementation programs, prime contractors are often larger research institutions or healthcare organizations. However, it is possible that small businesses could be involved as subcontractors, providing specialized services or support to the prime awardee. Further analysis would be needed to determine subcontracting opportunities and their impact on the small business ecosystem.

Oversight & Accountability

Oversight for this contract would primarily reside with the Agency for Healthcare Research and Quality (AHRQ), a component of the Department of Health and Human Services. AHRQ is responsible for overseeing the contractor's performance, ensuring adherence to the contract terms, and evaluating the effectiveness of the implemented safety program. Transparency is typically maintained through public reporting of research findings and program outcomes. Inspector General jurisdiction would apply to any potential fraud, waste, or abuse related to the contract funds.

Related Government Programs

Hospital-Acquired Infection Prevention Programs
Patient Safety Initiatives
Healthcare Quality Improvement Grants
Centers for Disease Control and Prevention (CDC) Infection Control Programs
National Institutes of Health (NIH) Health Services Research

Risk Flags

Implementation Fidelity Risk
Data Accuracy and Reporting Risk
Sustainability of Interventions Risk
Healthcare Staff Engagement Risk

Frequently Asked Questions

What is this federal contract paying for?

Department of Health and Human Services awarded $19.0 million to HEALTH RESEARCH AND EDUCATIONAL TRUST. NATIONAL IMPLEMENTATION OF COMPREHENSIVE UNIT-BASED SAFETY PROGRAM (CUSP) TO REDUCE CATHETER-ASSOCIATED URINARY TRACT INFECTION (CAUTI)

Who is the contractor on this award?

The obligated recipient is HEALTH RESEARCH AND EDUCATIONAL TRUST.

Which agency awarded this contract?

Awarding agency: Department of Health and Human Services (Agency for Healthcare Research and Quality).

What is the total obligated amount?

The obligated amount is $19.0 million.

What is the period of performance?

Start: 2011-08-15. End: 2015-08-14.

What was the specific methodology used by the Health Research and Educational Trust to implement the CUSP program nationally?

The Health Research and Educational Trust (HRET), as the contractor, likely employed a multi-faceted approach to nationally implement the Comprehensive Unit-Based Safety Program (CUSP). This typically involves providing standardized training modules, toolkits, and technical assistance to participating healthcare facilities. Key components often include educating frontline staff on teamwork and communication, empowering them to identify and report safety concerns, and implementing specific interventions targeting CAUTI prevention, such as proper catheter insertion, maintenance, and timely removal protocols. The implementation would likely involve a phased rollout, ongoing data collection on infection rates and process measures, and regular feedback loops to participating units and facilities to ensure fidelity and address challenges.

How does the $19 million expenditure compare to other federal investments in patient safety initiatives?

The $19 million expenditure for this national CAUTI reduction initiative represents a significant, but not unprecedented, investment in patient safety. Federal agencies like AHRQ and CDC regularly fund programs aimed at improving healthcare quality and preventing infections. For context, AHRQ's annual budget often includes substantial allocations for health services research and implementation science. While specific comparisons require detailed analysis of similar-sized, multi-year national programs, this award aligns with the scale of efforts needed to drive widespread adoption of evidence-based practices across a large healthcare system. It is a substantial investment aimed at achieving broad public health impact and reducing the considerable economic burden of healthcare-associated infections.

What were the primary risks identified during the contract period, and how were they mitigated?

Primary risks for a national implementation program like this could include variability in healthcare facility adoption and adherence, challenges in data collection and reporting accuracy, potential for staff burnout or resistance to new protocols, and the sustainability of interventions post-funding. Mitigation strategies likely involved robust training and technical assistance tailored to different facility needs, standardized data collection tools and validation processes, strong leadership engagement at participating sites, and developing strategies for long-term integration of CUSP principles into organizational culture. The firm fixed-price contract structure itself mitigates financial risk for the government, but operational and performance risks would have been actively managed by AHRQ through regular monitoring and contractor engagement.

What was the measurable impact of this contract on CAUTI rates nationally?

The measurable impact on CAUTI rates nationally would be a key outcome evaluated at the conclusion of the contract. While the raw data for this specific contract's final outcomes isn't provided, the success of such initiatives is typically assessed by comparing pre- and post-implementation infection rates in participating facilities. Studies on CUSP implementation have generally shown significant reductions in CAUTI rates when implemented effectively. The effectiveness of this particular $19 million investment would be detailed in final reports and publications by AHRQ, likely demonstrating reductions in infection incidence, associated morbidity and mortality, and potentially cost savings related to shorter hospital stays and reduced treatment needs.

How did the Health Research and Educational Trust's track record influence their selection for this contract?

The selection of the Health Research and Educational Trust (HRET) for this significant national implementation contract strongly suggests they possessed a relevant and successful track record. HRET, often affiliated with the American Hospital Association, has extensive experience in healthcare quality improvement, patient safety initiatives, and working directly with hospitals across the country. Their established relationships within the healthcare provider community, proven expertise in program dissemination, and demonstrated ability to manage large-scale projects would have been critical factors. A strong history of successfully implementing similar evidence-based programs and achieving measurable improvements in patient care would have made them a highly competitive and likely awardee in a full and open competition.

Industry Classification

NAICS: Professional, Scientific, and Technical Services › Scientific Research and Development Services › Research and Development in the Social Sciences and Humanities

Product/Service Code: RESEARCH AND DEVELOPMENT › N – Health R&D Services

Competition & Pricing

Extent Competed: FULL AND OPEN COMPETITION

Solicitation Procedures: NEGOTIATED PROPOSAL/QUOTE

Offers Received: 29

Pricing Type: FIRM FIXED PRICE (J)

Evaluated Preference: NONE

Contractor Details

Parent Company: American Hospital Association (UEI: 051064566)

Address: 155 N WACKER DR STE 400, CHICAGO, IL, 60606

Business Categories: Category Business, Nonprofit Organization, Not Designated a Small Business, Special Designations, U.S.-Owned Business

Financial Breakdown

Contract Ceiling: $19,003,529

Exercised Options: $19,003,529

Current Obligation: $19,003,529

Subaward Activity

Number of Subawards: 237

Total Subaward Amount: $31,872,170

Contract Characteristics

Commercial Item: COMMERCIAL ITEM PROCEDURES NOT USED

Cost or Pricing Data: NO

Parent Contract

Parent Award PIID: HHSA290201000025I

IDV Type: IDC

Timeline