Sunshine Coming for Hospital-acquired Infections

April 21, 2010 -- The Oregon Office of Health Policy and Research is getting ready to release the state’s first-ever public report on hospital-acquired infections next month. And preliminary data show room for improvement.

 

For procedures such as knee replacements, patients at one hospital were more than ten times likely to get an infection than at another facility. In the report that comes out, the names of those hospitals will be made public.

 

“The annual report will show in some detail the infections reported,” said Ron Jamtgaard, one of two designated consumer advocates on an advisory committee to the reporting program. “There is going to be so much information available in that.”

 

Whether or not people make consumer choices for elective procedures based on the public report doesn’t matter to Jamtgaard, who’s had several friends suffer from infections at hospitals – one having died. His goal is to reduce those infections by raising attention among hospital upper management, and he believes public reporting is one way to accomplish that.

 

“I’m motivated to try and reduce the number of infections because with sufficient management and attention it can be done,” Jamtgaard said. “I have no doubt about that.”

 

The report will represent the first tangible achievement for a program heralded as a victory for transparency when it was created by lawmakers in 2007. It wasn’t like they were stepping out on a limb, though. Oregon joined the majority of states that require public reporting of hospital-specific rates of infection.

 

Rep. Mitch Greenlick, a Democrat from southwest Portland, who led the drive to create the program as chair of the House Health Care Committee, said the process is moving much too slow.

 

"I'm very concerned. It's just going too damn slow,” Greenlick said. “If the hospital association is dominating the advisory committee and is dragging its feet, I'll keep pushing on it every time we get together."

 

Greenlick has made his intentions known during interim committee hearings. In response, the Office of Health Policy and Research has proposed a rapid expansion of the program over the next two years.

 

Reporting requirements would go from submitting data on four infection measures currently tracked to including five additional measures every six months beginning in January 2011. Included would also be specific reporting of the controversial multi-drug resistant staph infection, known as MRSA, which was not included in the first round of public reports. Rulemaking for the next phase will begin this summer.

 

At a March 10 advisory board meeting, several hospital representatives reiterated their arguments for a go-slow approach based on the added cost and administrative burden demanded by such reporting. The additional costs, they insisted, may defeat other efforts to actually reduce the causes of infection.

 

“This is already a tremendous burden,” said Jodi Joyce, vice president of quality and safety at Legacy Health System. “Our organization is fully committed, but this is going to fundamentally jeopardize the progress we’ve made. Time spent reporting is time not spent improving.”

 

But Dee Dee Vallier, the other consumer advocate on the board, reminded Joyce that her family was forced to declare bankruptcy because her husband received a hospital-acquired infection. He went in for a $20,000 procedure only to have it cost $240,000 due to complications, she said.

 

“We had to declare bankruptcy,” Vallier said. “I’m sorry this is going to cost hospitals some money.” 

 

Improvements in patient safety at U.S. hospitals continue to lag despite a decade of effort, according to a report on quality by the HHS Agency for Healthcare Research Quality.

 

In a silver lining, the report cites clear improvements since CMS instituted its Hospital Compare Web site and other public reporting programs.

 

Read the full report here.

 

For related articles on infection rates at The Lund Report click here. 

 

For meeting materials and details about proposed reporting measures click here.