- centerforhealthreporting.org/project/death-complication-hospital-infection-threat
- centerforhealthreporting.org/article/graphics-hospital-acquired-infection-rates
- centerforhealthreporting.org/article/legislators-disappointed-states-infections-performance
- centerforhealthreporting.org/content/state-not-backing-its-own-infection-data
Provide names of other journalists involved.
Philip Reese, Sacramento Bee data reporter
List date(s) this work was published or aired.
May 29 and May 30, 2011
Provide a brief synopsis of the story or stories, including any significant findings.
California passed two strong laws to assure that if patients are infected during hospital stays, those hospitals must notify state regulators. The state, in turn, must provide data on these infections in public reports. But the state’s first accounting, issued in December 2010, contained serious defects. Although the Legislature intended these reports to educate consumers, this one was based on what the state itself labeled unreliable data. The format was virtually impenetrable. To find out why, our Center teamed up with the Bee to probe state oversight of hospital infections. We learned about surveys that started late, hospitals that never reported, data from hundreds of hospitals so incomplete that the state never made the numbers public, quietly dumping them instead. Some hospitals’ records had sat untouched in storage for more than a year, even as deadlines loomed. And as of 2011, the state was only just starting to write regulations required by laws passed in 2006 and 2008. At the same time, the state was warning consumers not to make much of the information. But this advice was flat-out wrong. In fact, Deborah Schoch concluded the data contained remarkable findings about the variability of hospital infections in California. And, as she discovered, this unevenness has deadly consequences. An estimated 13,000 people die early in California from hospital infections, three times the number that die in traffic accidents. Our two-day series consisted of three main stories, three sidebars, photos, video and an informational graphic with area hospital infection rates. Three maximum three pieces are submitted here.
Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
–We relied heavily on California’s first hospital-specific public reports on hospital acquired infections, released Dec. 30, 2010 –We had to file a state Public Records Act request to obtain the data in Excel format for analysis. We also obtained and analyzed federal CMS infection data. –We accessed minutes and emails of the state’s HAI advisory panel. –We obtained Lewis’ medical records from his family. We also obtained a waiver signed by the family so that hospital officials would discuss the case with us.
Explain types of human sources used.
–16 patients and/or families statewide, including Lewis’ family, with experience in infections. –Staff at Lewis’ hospital and at other hospitals in the region and state. –state and national hospital and infection control associations and members of state’s advisory panel. –health care employee unions –Patient advocate groups, including Consumers Union and Niles’ Project –National infection expert. –California legislators on key committees, and their staffs. –Health agencies in New York, Pennsylvania and Michigan. –Official and unofficial sources in state and federal agencies, including the state health department, CDC, CMS and the federal Agency for Healthcare and Quality.
Results:
The state’s second HAI report, issued Jan. 6, 2012, included much stronger data and analysis for more hospitals and infection types. This time, officials said that the data analysis for some infections would indeed allow hospital comparisons. We can’t take full credit. But our project sparked hundreds of comments and emails from readers. It prompted a strongly worded Bee editorial. Most of all, it explained why hospital infection data should be put in full public view.
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.
No.
Advice to other journalists planning a similar story or project.
Search out data so that you can measure the performance of your local hospitals. Find out if your state is one of more than two dozen nationally requiring HAI reporting. If so, get the annual reports–all of them, since reporting began–and look for trends. Pinpoint the outliers, both good and bad. Compare the quality of your state’s reporting to that of other states. Hunt down the ever-increasing amount of data kept by the Centers for Disease Control and Prevention. But don’t get consumed by the data. Seek out people who have been affected by hospital infections. Comb through news stories. Make queries on Facebook or on your media outlet’s website. When you find patients, or their survivors, ask for medical records and verify them. Talk to doctors who cared for them. Allow the hospital plenty of time to respond.