Tag Archives: health care associated infections

Disclosure of hospital infections still in its infancy

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

On Forbes.com, Gergana Koleva evaluated the woeful state of national hospital-associated infection reporting, with the help of recently published research. As Koleva writes, such infections account for more than 8,000 deaths each year in the United States and add an estimated $10 billion in annual cost, and hospitals routinely collect valuable data on such things for internal use, yet no clear reporting standards exist on a national level.

The report … shows that only 21 states currently have legislation that requires monitoring and public reporting for surgical site infections. Of those, only eight states actually make the data publicly available, and only a total of 10 procedures – out of 250 possible types of surgeries – get reported.

And even many those states that reported some surgical infection rates as of late 2010 (Colorado, Massachussetts, Missouri, New York, Ohio, Oregon, South Carolina, and Vermont)

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CHCH Center, Sac Bee investigate hospital-acquired infections

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

In a series titled “Death by Complication,” the California HealthCare Foundation Center for Health Reporting and The Sacramento Bee teamed up to investigate hospital-acquired infections in the state as well as efforts to combat them.

In the centerpiece, the CHCF’s Deborah Schoch used records and privacy waivers granted by a cooperative family to explore how an apparent hospital-acquired C. difficile infection seems to have killed an otherwise healthy 75-year-old man who was originally hospitalized for a broken femur. The cause of death was listed as “complications.” His story was far from unique, Schoch writes.

One in 20 hospital patients get infections. In California, roughly 200,000 people get hospital infections annually, and 12,000 of them die, according to state Department of Public Health statistics. That makes such infections one of the state’s leading causes of death, ahead of automobile accidents and Alzheimer’s disease.

Yet these deaths have remained mostly in the shadows. They often are classified as “deaths from complications,” an oblique term used in obituaries and often unquestioned by relatives and friends.

Even the best doctors can be baffled whether an infection was acquired before or after a patient was admitted, and if it was the principal cause of death or no factor at all.

Many health care providers historically have viewed hospital infections – going by obscure names or acronyms such as C.diff, CLABSI, VRE and the more familiar MRSA – as a sometimes inevitable consequence of being hospitalized.

In related pieces, reporters find that while hospitals are waking up to the toll taken by hospital-acquired infections, neither they nor the state have really managed to take authoritative measures to address the problem.

See the full series, complete with infographics, on CHCF’s site.

Hospitals to start reporting infection data Jan. 1

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

Hospitals are set to begin reporting information about hospital-acquired bloodstream infections to the federal government on Jan. 1, with the data becoming available to the public later in the year through the Hospital Compare website, according to an article by Tony Pugh of McClatchy Newspapers. Pugh also reports that hospitals will start reporting on surgical site infections in 2012.

The article includes a graphic that shows what states currently require public reporting of hospital-acquired infections.

While reporting to Hospital Compare will be voluntary, hospitals that fail to comply will “lose 2 percent of their Medicare funding beginning in fiscal year 2013.”

There are nearly 250,000 catheter-related bloodstream infections a year in U.S. hospitals, contributing to roughly 31,000 patient deaths annually. There are more than 290,000 surgical site infections a year, contributing to more than 8,200 deaths.

(Hat tip to FairWarning.org)

Reminder: AHCJ has compiled easy-to-use Excel spreadsheets of much of the data currently available from Hospital Compare. The up-to-date files, available to AHCJ members, are designed to allow you to compare more than three hospitals at a time – unlike the Hospital Compare look-up tool – using spreadsheet or database software to filter, sort and use other analysis tools with precision. You can look at hospital mortality and readmission data, as well as patient satisfaction.

AHCJ will be looking at making the new infection data available to members similar to what it offers for the mortality, readmission and patient satisfaction data.

AHCJ also has tip sheets to help you understand and analyze the data:

Wash. health data now includes infection rates

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Washington state has solidified its position as a leader in health data transparency with the publication this year of hospital surgery infection rates. The data is broken down hospital-by-hospital and includes numbers for the rates of certain infections following cardiac surgery, orthopedic surgery and hysterectomy, as well as for compliance with infection prevention numbers. For more numbers, including some which have been published for several years now, visit the state hospital association’s transparency center.

The unexpected highlight of this year’s data? A press release, pointed out by blogger and hospital executive Paul Levy, in which the Washington State Hospital Association official proudly announces that “Washington’s hospitals are enthusiastic participants in providing this new information about surgical infection rates.” Credit for this transparency lies with state lawmakers, but the hospitals deserve some props for publicly embracing the effort as well.

Missouri data disclosure details infection fight

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Missouri law requires hospitals to disclose infection rates for intensive care and certain surgeries. It doesn’t keep that data around for long, but St. Louis Post-Dispatch reporter Jim Doyle still managed to review data from 2005 to 2009.


Robots sanitize an ICU room by spraying hydrogen peroxide vapor into the air at St. John’s Mercy Medical Center.

He found that while numerous local hospitals lagged behind national infection rates, most were improving. A story that could have been a dire assessment of health care-associated infections instead became (mostly) a profile of local hospitals’ drive to cut down on the transmission of such infections. He doesn’t draw a clean line between the state’s monitoring and increased anti-infection efforts, but it’s tempting to read between the lines.

Doyle’s second installment continues the theme, discussing the aggressive, nonstop effort that is required to contain drug-resistant bacteria. Measures range from checklists to room-enveloping antibacterial vapors.

Missouri’s disclosure laws are an important step toward infection fighting, Doyle found, but their narrow definition allows hospitals some wiggle room and may miss serious systemic issues. Speaking of systemic issues, I highly recommend Doyle’s sidebar on why Missouri infection data is so hard to keep around.

Outpatient inspections show serious lapses

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

cms2567

AP medical reporter and AHCJ board member Carla K. Johnson used FOIA requests to uncover a wealth of infection-control violations at outpatient clinics in Illinois. The majority of Illinois ambulatory centers have yet to be inspected under the tough new rules, but 76 percent of those which have been inspected also have been cited. The inspections are part of a national push to increase the oversight of ambulatory care centers.

Previously, inspectors from the Illinois Department of Public Health visited the centers about every seven years. But the state last year began more vigorous and frequent inspections of outpatient surgery centers, following directives from national health officials. The state now plans to inspect a third of Illinois centers each year, said Karen Senger, a supervisor in the Health Department’s Division of Health Care Facilities and Programs.

The crackdown resulted from a hepatitis C outbreak in Las Vegas believed to be caused by unsafe injection practices at two now-closed clinics.

Johnson’s state request turned up a laundry list of specific violations, all of which she summarized in one nifty sentence: “The five-second rule appears to be alive and well in Illinois same-day surgery centers, where medical staff were observed picking up items that had fallen to the floor and behaving as if they weren’t contaminated by germs,” Johnson wrote. In an e-mail to Covering Health, Johnson said her story should be easy to localize and explained just how she obtained the inspection reports and why they are now available.

I FOIA’d state inspection reports (CMS-2567s) for ambulatory surgery centers in Illinois that were cited for deficiencies in infection control during the past 12 months. States have been directed by HHS to use a new audit tool to look for infection control problems, following an outbreak linked to two centers in Las Vegas.