hospital acquired infections

Blue Shield of California Foundation expands hospital-infection program

Anne Zieger — Fri, 11 Jul 2008 09:22:50 -0400

Having gone through a nine-hospital pilot effort, the Blue Shield of California Foundation is expanding a program to prevent hospital-acquired infection. The expanded program will include 55 facilities, far short of the 100 volunteer hospitals the foundation was hoping to attract, but still enough to move ahead. Under the expanded program, the Foundation hopes to see 2,000 fewer patients contract HAIs, 15,000 fewer inpatient days, and $30 million less costs to patients and hospitals. Under the 18-month pilot, more than 600 infections were prevented, resulting in 4,640 fewer unnecessary hospital days and saving $9 million.

All of the 55 hospitals participating in the program will get training from nationally-recognized infection prevention leaders, focusing on six common types of HAIs. These include MRSA, central line bloodstream infections and urinary tract infections. Meanwhile, 14 of the participating non-profit hospitals will get grants from the Foundation to help them buy data-mining software that will be used to help the facilities find and treat these infections.

Other hospitals in the state are already participating in several HAI-prevention and quality-improvement initiatives, including northern California's Beacon Collaborative, the southern California Patient Safety Collaborative, the Children's Hospital Collaborative or the Institute for Healthcare Improvement's quality-improvement programs.

To learn more about the program:
- read this San Francisco Business Times piece

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Study: Hospitalized kids suffer too many infections

Wed, 04 Jun 2008 06:59:54 -0400

A new study released this week concludes that hospitalized children suffer a high rate of infections and other preventable complications that lead to longer stays and cost millions of dollars. The study, which appears in this month's issue of the journal Pediatrics, found that some types of complications occurred in as many as 4 percent of children treated at 38 children's hospitals in the U.S., in part because children are three times more susceptible to infections in hospitals than adults.

To conduct the study, researchers looked at medical records from thousands of children hospitalized in 2006, looking for 12 adverse events identified by the Agency for Healthcare Research and Quality. They found that of 430,000 children hospitalized in 2006, more than 6,600 suffered complications caused by their care, including nearly 3,000 cases of infections caused by care. Complications increased lengths of stay from three days for an accidental laceration to 24 days for sepsis. Added costs ranged from $35,000 to $337,000, researchers concluded.

To learn more about the study:
- read this piece in The Seattle Times

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CA hospital forced to stop cardiac surgeries due to infections

Thu, 29 May 2008 06:59:54 -0400

A Fresno hospital has been forced to stop performing open-heart surgeries while state public health authorities investigate a new surge in post-operative infections.

Last year, the CDC investigated bacterial infections that made at least a dozen patients at Saint Agnes Medical Center sick, and possibly contributed to two deaths. At the time, the CDC noted a surgeon with an abnormally high number of affected patients, but was unable to pinpoint a cause for the infections. Earlier this year, state health investigators found no health violations after inspecting the cardiac surgery unit.

The hospital is still performing emergency heart surgeries, but the California Department of Public Health recommended this weekend that the facility stop performing non-emergency procedures.

To learn more about the infections:
- read this piece in the San Francisco Chronicle

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Feds to display hospital satisfaction ratings in newspaper ads

Wed, 21 May 2008 06:59:56 -0400

In an effort to put some money behind its philosophy, the federal government has budgeted about $1.9 million to put full-page ads in newspapers around the U.S. disclosing individual hospital satisfaction rates. The newspaper ads, which are running in 58 newspapers in 49 states, draw their data from CMS's Hospital Compare website (http://www.hospitalcompare.hhs.gov). The patient satisfaction data used in the campaign was released voluntarily by the hospitals in question.

The ads will show responses to two questions: the percentage of patients who always received help when they needed it, and the percentage who received antibiotics one hour before surgery. The second question relates to a measure commonly held to be important in fighting hospital-acquired infections. In addition to listing specific hospital numbers, the ads will list statewide averages for the given survey question.

To learn more about this campaign:
- read this Associated Press article

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Case study: NY hospitals lower ICU infection rates

Fri, 16 May 2008 06:59:54 -0400

In recent times, New York City's public hospitals have mounted an effort to lower the rate of infections patients acquire in in their intensive care units. The effort, by the New York City Health and Hospitals Corp., has been a significant success, with ventilator-associated pneumonia falling by 78 percent between 2005 and 2007 and central-line infections by 55 percent. Surgical-site infection rates dropped too. Today, the system now says it has 3.4 central-line infections for every thousand days patients spend with the catheters, as compared with an average rate of 5.3 per thousand suggested by some studies.

To make this turnaround, the system's 11 facilities focused on process "bundles" designed to address infection causes. For example, ventilator patients got vacations from sedatives that can raise infection risks, and their heads were elevated. When treating patients with central lines, hospital staffers were careful to engage in frequent hand-washing, as well as draping the catheter entry point to protect it from other areas of the body which could pass bacteria to the site.

To learn more about this effort:
- read this Wall Street Journal blog item

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C. diff threat growing across the U.S.

Mon, 05 May 2008 06:59:56 -0400

Clostridium difficile has long been known to providers as a common but easily-treated bug whose symptoms aren't a big deal. However, of late a drug-resistant strain of C. diff has become more common, posing far greater risks to patients. In fact, some health officials now rank C. diff on par with MRSA as a top infection acquired in hospitals. And it's tough to fight; typical germicides and alcohol sanitizers don't kill it, nor does routine cleaning of surfaces.

Overall C. diff infections in the U.S. have more than doubled since 2000. The NAP1 type of the bacteria, which produces 20 times the toxins of a more benign form, can cause devastating symptoms that can sometimes be lethal. In 2005, almost 10 percent of the patients who were diagnosed as having the bug died. However, some officials think the infection and death rates from C. diff may be much higher, as providers currently aren't required to report the presence of the bug.

To learn more about C. diff's spread:
- read this MSNBC.com article

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Case study: WI hospital wins Baldridge with tough standards

Thu, 24 Apr 2008 06:59:54 -0400

A Wisconsin health system has become one of five Malcolm Baldridge National Quality Award winners by racking up a wide range of successes cutting across employee satisfaction, patient safety and outcomes measures. The system--Janesville, WI-based Mercy Health--won the award in part because it managed not only to lower total mortality rates to levels matching the top 15 percent of all hospitals nationwide, but also brought employee and physician satisfaction rankings to the 95th percentile and cut hospital-acquired infections to below best-practice benchmarks. This came despite the system's rapid growth in revenue, which has climbed from $33 million a year $850 million during the years between 1989 and the present.

How did Mercy accomplish this? Among other moves, executives there have been reviewing key metrics on quality, service and costs, and if the system's stats fall below 93 percent for a benchmark, the CEO immediately forms a team to find out why and address the problem. This includes every aspect of the system's operations, from housekeeping to bedside care.

To learn more about Mercy Health's accomplishments:
- read this Milwaukee Journal Sentinel article

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CA hospital project cuts HAI rates

Tue, 22 Apr 2008 06:59:54 -0400

A group of San Francisco-area hospitals have managed to cut their rates of infection for two common hospital-associated conditions substantially over the last year and a half. The group, The Beacon Collaborative, is a voluntary association of 39 hospitals. The hospitals began joint HAI-reduction programs in April 2006 and ran tests at the end of 2007 to determine their progress. According to their analysis, during the 21 month period, 34 of the 39 Beacon hospitals prevented 60 percent of the expected cases of ventilator-associated pneumonia and 66 percent of central line-associated bloodstream infections. The group estimates that the reduction in ventilator-associated pneumonia saved an estimated 194 lives and almost $4 million in unnecessary hospital costs, while the reduction in central line-related infections saved an addition 74 lives and $2.7 million.

To learn more about the effort:
- read this East Bay Business Times item

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GAO says gov't needs to create HAI prevention standards

Fri, 18 Apr 2008 06:59:55 -0400

A new report from the Government Accountability Office suggests that the federal government should step up to the plate and set standards for hospitals to follow in preventing hospital-acquired infections. Medicare and the CDC, in particular, should establish clear guidelines as to which infection-control practices they consider to be most important, the GAO said. The CDC, for example, strongly recommends that hospitals follow an imposing 500 practices, far more than hospitals can reasonably implement over the short term, hospital industry leaders say. The report also argues that federal regulators should do more to push hospitals to meet such standards, noting that private groups like doctors, hospitals and employers have done far more to nudge hospitals in that direction.

To learn more about the report:
- read this Baltimore Sun piece

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GAO: HHS agencies need to collaborate to fight HAIs

Thu, 17 Apr 2008 06:59:57 -0400

If they're to make any real progress in fighting hospital-associated infections, HHS agencies will need to work together more closely, according to the Government Accountability Office. GAO director for healthcare issues Cynthia Bascetta told Congress that while the various agencies with a stake in fighting HAIs--including CMS, the CDC and the AHRQ--"have a sense of urgency" about the problem, they're not working together closely. At present, they're largely limiting their collaboration to updating each other on their independent databases, she told the House Committee on Oversight and Government Reform. According to a report the GAO released at the committee hearing, the agencies would do better if they created links across these databases--something that would allow all of the agencies involved to better understand where and how hospital infections are acquired.

To learn more about GAO's recommendations:
- read this Modern Healthcare piece (reg. req.)
- read the GAO report (.pdf)

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