- http://usatoday30.usatoday.com/news/health/story/2012-08-16/deadly-bacteria-hospital-infections/57079514/1
- http://www.usatoday.com/story/news/nation/2012/11/29/bacteria-deadly-hospital-infection/1727667/
- http://www.usatoday.com/story/news/nation/2012/12/26/infections-needles-mrsa-hospitals/1780335/
- http://www.usatoday.com/story/news/nation/2012/10/11/compounding-pharmarcies-deaths/1626753/
Provide names of other journalists involved.
Editing by John Hillkirk and Terry Byrne; Online video production by Shannon Green
List date(s) this work was published or aired.
This occasional series of stories began on Aug. 16, 2012 and ran through the end of the year. Stories will continue in 2013. All stories were published with a common sig: When Healthcare Makes You Sick.
Provide a brief synopsis of the story or stories, including any significant findings.
This series of stories examines the scope and impact of an epidemic of healthcare-associated infections plaguing hospitals, clinics, nursing homes, and other medical facilities across the country. It finds that healthcare-related deaths and illnesses among patients in these settings are far more common than government statistics suggest. For example, C diff is killing almost 30,000 Americans every year – nearly twice what the CDC has estimated until now. And the medical community lacks the will, wherewithal and resources to tackle the problem effectively. Some of the most persistent infections, such as Clostridium difficile, or C. diff, are becoming more prevalent even though there are proven strategies for cutting incidence rates. Meanwhile, the emergence of new, antibiotic-resistant superbugs in healthcare facilities is bringing an added layer of threats, raising the risk that patients who seek care for basic ailments will contract illnesses that simply cannot be treated. Still, many medical institutions have not heeded urgent recommendations from government agencies and public health officials on how to control these infections — from relatively easy steps, such as improving sanitary practices and room cleaning, to more complex initiatives aimed at curbing the overuse or misuse of antibiotics. The series shows that problems as basic as the use of dirty needles continue to impact hundreds of thousands of Americans each year. The stories included on-line videos and often complex, interactive graphics to help readers understand both the mechanics and impact of healthcare-associated infections. The videos allowed victims to tell their stories in their own words, while also giving doctors and public health experts a chance to provide their perspective on the problem – and revealing the details on cases most Americans have never heard about before, including the deaths of seven patients at the University of Virginia Medical Center.
Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
This series relied largely on federal data collected from the U.S. Agency for Healthcare Research and Quality, and the Centers for Disease Control and Prevention. Both agencies provided the data on request, so no FOI requests were necessary. The reporting also made extensive use of federal, state and local records on outbreaks of healthcare associated illnesses. Some of those records, such as reports on outbreak investigations by county and state health departments, were available on the Internet; others were provided in response to the newspaper’s requests. In states where hospitals are required to report their incidence rates of healthcare associated infections, we also made use of that data, which was publicly available. To locate victims and compile case studies, we also made extensive use of various legal databases, such as Lexis and Courtlink, to dig up court records and other documents.
Explain types of human sources used.
The series involved scores of interviews with public health officials at the federal, state and local level, as well as doctors, nurses, and infection control specialists. We also spoke with independent experts at academic institutions and think tanks who have studied healthcare-associated infections. But most of the stories’ power came from the stories of real people who have suffered healthcare infections themselves or lost loved ones to those illnesses. For just one piece, on C. diff, we recounted the stories of about 20 people who suffered or died with the illness.
Results:
The series is ongoing, so it’s not yet clear what results it ultimately will produce, but it already is having significant impact. For example, after USA TODAY found that annual deaths associated with C. diff were roughly double the 14,000 reported by the CDC, the agency began changing its literature to reflect the higher number. After our story on the emergence of a new family of antibiotic-resistant bugs in healthcare facilities, CDC officials were contacted by Congressional staff in what became an ongoing series of discussions on what sort of policy solutions might be available to help combat the problem. And the story on unsafe injection practices prompted a flurry of follow-up. The CDC tweeted the story and posted it on multiple listservs; the AARP wrote a long blog post about the piece, urging members to protect themselves from dirty needles by following recommendations included in the story (http://blog.aarp.org/2012/12/28/dirty-needles-how-some-clinics-endanger-older-patients/); and William Heisel featured the in USC Annenberg’s Reporting on Health blog, praising it as an “impressive” example of investigative health reporting that holds important lessons for other reporters (http://www.reportingonhealth.org/2012/12/30/double-dipping-five-tips-usa-today’s-injection-safety-investigation). All of the stories have been picked up widely by other news organizations. Each piece was distributed over Gannett newswires and parts of the series were featured in dozens of newspapers. We also worked with television stations that produced their own versions of our pieces, often relying partly on the videos or graphics we produced for the USA TODAY website. Series author Peter Eisler was invited to appear on a number of radio and television interviews in connection with the series, including shows that aired on the National Public Radio network and on major-market commercial stations.
Follow-up (if any). Have you run a correction or clarification on the report or has anyone come forward to challenge its accuracy? If so, please explain.
The series is ongoing, so we have not produced any follow-up stories yet. We did have a typo in our story on unsafe injections that resulted in us publishing an incorrect time frame for the advent of the disposable syringe (the story said that disposable syringes came into use 150 years ago, but should have said 50 years ago). The story was corrected on the web the day it was published and a correction also ran in the print edition of the paper.
Advice to other journalists planning a similar story or project.
Look at the data: we found some of our best pieces by studying federal data on incidence rates for different types of healthcare associated infections. For example, we noticed that while many HAIs, such as MRSA, have shown some decline, rates for C. diff continue to rise. This spurred us to focus on C. diff for our initial story and led to other data showing that the number of people dying with C. diff infections each year is roughly double the CDC’s official estimate. Similarly, we were surprised to see the number of public health warnings associated with unsafe injection practices, which led to another story. The CDC has data on outbreaks of different illnesses, broken down in some cases by setting. And the U.S. Agency for Healthcare Research and Quality collects great data on hospital admissions and discharges – their statisticians are very open to talking with reporters and extremely knowledgeable. Also, many states are starting to require that hospitals (and, in some cases, nursing homes, too) report their rates of various healthcare infections, such as MRSA, surgical site infections, catheter-related infections and even C. diff. If your state health department collects this information, it can be extremely useful in tracking infections trends at healthcare facilities in your community.
Look for the numbers that don’t exist: Often, there are great stories in what health officials DON’T know. We got some powerful findings by pointing out that state and federal health agencies weren’t collecting data that public health officials need desperately. As one officials told us, if you don’t know the scope of a problem – where it’s emerging and how quickly – it’s very difficult to develop effective strategies to combat it.
Talk to victims: Don’t wait until the end of your reporting to reach out to victims – they often have information that can lead to significant new findings. Many victims become self-appointed patient advocates, and they sometimes have a better grasp of particular problems than public health officials. Many have educated themselves to the point where they have great expertise, and they often know the best experts, the best studies, and the facilities with the best and worst records.
Start local: Talk to local and state health officials to get a handle on emerging problems. Many hospitals have doctors or nurses dedicated to infection control. APIC, the Association for Professionals in Infection Control and Epidemiology, can put you in touch with infection control specialists at particular hospitals or in specific regions, and they can be great resources. County health departments also are a terrific source of information. Get to know them and find out what sort of data they and/or their state counterparts collect from local hospitals. Those figures can be a great source of stories. Also, county health departments usually are heavily involved in investigations of local illness outbreaks, so it’s worth developing relationships that will yield tips when an investigation is underway.