Hospital infections (HAIs): how technology reduces risks

Hospital infections, technically called healthcare-associated infections (HAIs), are one of the biggest challenges in hospital management today. They are not limited to the clinical field: they are direct indicators of quality of care and patient safety.

Every preventable infection means extra days in the hospital, use of high-cost antibiotics, risk of sepsis, higher mortality and a high probability of a clinical denial. That is why HAI control has become a strategic topic for directors, financial managers and clinical leaders.

What are HAIs and which are the most frequent?

A hospital infection is any infection caused by microorganisms (bacteria, viruses or fungi) acquired during the hospital stay or directly related to the care provided. It can therefore appear during hospitalization or after discharge.

The most frequent HAIs are directly associated with invasive procedures, medical devices and surgeries. The hospital environment brings together immunologically vulnerable patients undergoing multiple interventions, which increases the risk of infection when protocols are not strictly followed.

The main types seen in Brazilian institutions include:

• Urinary tract infection (UTI): usually associated with prolonged use of a urinary catheter, often without daily reassessment of the need for it.

• Ventilator-associated pneumonia: common in ICU patients, with a direct impact on ventilation time and mortality.

• Bloodstream infection: often related to central venous catheters and failures in insertion or maintenance technique.

• Surgical site infection (SSI): occurs in surgical wounds and can lead to reoperations, prolonged antibiotic use and delayed recovery.

Surgical and critically ill patients are at significantly higher risk. Without continuous monitoring, a condition that is initially under control can quickly progress to sepsis, one of the main causes of preventable death in the hospital setting.

What is the financial impact of hospital infections?

The human consequences of HAIs are serious, as they are often a condition that leads to death. In addition, the economic impact on the health system is significant. In Brazil, care failures during hospital stays (including hospital infections) generated an estimated cost of more than R$ 10 billion for the private healthcare system.

Clinical inefficiency translates into:

• a longer average length of stay;

• high consumption of broad‑spectrum antibiotics;

• additional tests and procedures;

• a higher denial rate from payers.

Ministry of Health estimates indicate that HAIs may affect up to 14% of hospital stays; in other words, out of every 100 hospitalized patients, about 14 develop some type of healthcare-associated infection. In addition, thousands of deaths a year are associated with infectious complications acquired in the hospital environment.

How does intelligent auditing help prevent HAIs?

Unlike retrospective audit, which analyzes failures only after the patient is discharged, concurrent audit works while care is being provided. This makes it possible to identify risks and protocol deviations in real time, when it is still possible to intervene.

With the support of technology, auditing can cross-check clinical data, physician progress notes, prescriptions and care records against institutional protocols and safety guidelines. Practical examples include:

• alerts for catheters left in place longer than recommended;

• identification of antibiotics started without a culture or adequate clinical justification;

• missing mandatory nursing records or physician progress notes;

• breaches of surgical prophylaxis protocols.

This kind of approach makes it possible to target training at recurring failures and specific departments, reduce the average length of stay and prevent avoidable adverse events and their associated costs.

Why does value in healthcare depend on HAI control?

The concept of Value in Health (which in healthcare connects to the idea ofValue-Based Healthcare), popularized by Michael Porter, helps explain why infection prevention has become a strategic priority. The equation is simple:

Value = Care Outcomes / Total Costs

The better the clinical outcome and the lower the cost of achieving it, the greater the value delivered. In this context, patient safety and the prevention of adverse events carry more and more weight.

In value-based payment models, preventable infections mean a direct drop in performance. In the United States, since 2008, hospitals have not been reimbursed for costs related to certain preventable adverse events, known as never events. In Brazil, as similar models evolve, institutions that do not control their HAI rates face a greater risk of denials, unfavorable contract renegotiation and loss of competitiveness.

What does Law No. 9,431 require of healthcare institutions?

Law No. 9,431/1997 requires every healthcare institution in the country to maintain a Hospital Infection Control Program (PCIH), with the goal of reducing the incidence and severity of healthcare-associated infections.

The law requires the hospital to have systematic, continuous and documented actions capable of preventing, monitoring and intervening on infection risks throughout the patient journey.

This includes, among other points:

• active epidemiological surveillance of hospital infections;

• definition and tracking of care indicators;

• clear protocols for the use of antimicrobials and invasive devices;

• ongoing training of multidisciplinary teams;

• recording and traceability of control actions.

Failing to meet these requirements exposes the institution to regulatory sanctions, legal risks, contractual weakness with payers and a direct impact on hospital accreditation. In addition, the absence of objective evidence of monitoring makes it harder for the hospital to defend itself in external audits and denial proceedings.

How does technology help reduce hospital infections?

Technology makes it possible to turn scattered care data into alerts for the clinical and audit teams. Based on continuous analysis, the system identifies nonconformities that increase the risk of infection and notifies those responsible in a structured way.

This daily monitoring reduces the likelihood of transmitting multidrug-resistant microorganisms, improves protocol adherence and strengthens the patient safety culture. In practice, fewer infections mean fewer extra days in the hospital, fewer non-reimbursable costs, greater financial predictability and, most important of all, lives saved.

The Rivio View

Preventing hospital infections and financial sustainability are part of the same cycle. Preventable adverse events generate additional costs, which often result in clinical denials and invisible revenue losses.

With Rivio’s AI platform, it is possible to automate critical stages of the hospital revenue cycle, from care to medical audit, through clinical review and submission of the XML to payers. The technology identifies discrepancies, reduces denials and ensures the hospital is paid in full for the care provided.

More than recovering amounts, Rivio works to keep the loss from happening, supporting care decisions that are safer and financially sustainable.

FAQ – Frequently asked questions about hospital infections

1. What is a hospital infection (HAI)?

It is any infection acquired after the patient is admitted to the hospital, directly related to the care or procedures performed.

2. What are the main types of hospital infection?

Ventilator-associated pneumonia, catheter-associated urinary tract infection, bloodstream infection and surgical site infection.

3. How does concurrent audit help with prevention?

It monitors care in real time and alerts to protocol deviations that increase the risk of infection, allowing immediate corrections.

4. What is the financial impact of HAIs on hospitals?

Beyond the clinical impact, they generate billions of reais in additional costs from prolonged hospital stays, expensive medications and procedures that are often not reimbursed.

5. What is value‑based payment?

It is a payment model that prioritizes quality of care and clinical outcomes, not just the volume of services provided.

6. How does artificial intelligence identify infection risks?

AI analyzes clinical progress notes, prescriptions and care records for patterns that indicate protocol failures or the onset of infectious processes.

7. Why is hand hygiene so important?

Because healthcare professionals’ hands are the main vector for transmitting microorganisms in the hospital environment.

8. What is hospital sepsis?

It is a severe systemic inflammatory response resulting from an infection, which can lead to organ failure if not identified early.

9. How do control indicators help management?

They show where care failures occur, enabling corrective actions and targeted training.

10. What is the relationship between denials and hospital infections?

Payers often refuse to pay for additional costs when they find that these costs were generated by preventable adverse events.