How do you judge a hospital’s quality: By how caring the nurses are? By the doctors’ credentials? By the technologies it offers?
How about by how likely patients are to get an infection while in its care? A bill sponsored by state Sen. John F. McBurney III (D-Pawtucket), based on a Consumers Union model law, would require the state Department of Health to collect infection data from every hospital and produce annual reports, in easy-to-understand language, for the public and policy-makers.
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McBurney did not return calls seeking comment about his bill, but a Consumers Union Web site, stophospitalinfections.org, notes that hospital infections kill more Americans each year than auto accidents and homicides combined.
The Centers for Disease Control and Prevention has estimated that about 2 million people – 5 percent to 10 percent of all hospital patients – contract infections each year, ranging from relatively minor urinary tract or surgical site infections, to pneumonia and severe blood infections. About 88,000 people die as a result.
Not only does this hurt patients, the CDC has said, but as of 2000, it was adding nearly $5 billion to U.S. health costs, about $5,000 for each patient who got pneumonia, and $50,000 or more for prolonged bloodstream infections, which can extend a hospitalization by a month.
The infection rate has risen since the 1970s due to the growing use of breathing tubes, intravenous lines and other invasive treatments, the CDC has said, but it would’ve spiraled even higher if hospitals had not begun implementing quality-control programs.
Good infection-control measures – as simple as regular hand washing, and more careful catheter insertion – have been shown to cut infection rates by as much as 70 percent, Consumers Union says, but many hospitals aren’t doing enough. And because infection data is only kept in-house, if at all, patients have no way of knowing how safe each hospital is.
To change that, the consumer group has been pushing for mandatory hospital infection reporting. Since 2003, Pennsylvania, Illinois, Missouri and Florida have passed such laws, and at least 15 states, including Rhode Island, have bills pending this year.
The local bill, which is awaiting a hearing before the Senate Health and Human Services Committee, would require hospitals to keep data on surgical site infections, ventilator-associated pneumonia, central line (IV)-related bloodstream infections, urinary tract infections and any other infection types the Department of Health determines.
The data would be reported quarterly, and once a year, health officials would compile it into a public report, “as easy to comprehend as possible,” with hospital-by-hospital comparisons.
Asked for comment, Assistant Health Director Robert J. Marshall said requiring infection rate reporting “is a useful idea,” because infections are “an important part of the quality of hospital care.” But rather than create a whole new reporting system, he said, the state might want to add infections to the Department of Health’s existing quality performance measurement and reporting program, which all hospitals work with.
Cathy Duquette, clinical expert for the Hospital Association of Rhode Island, also said that would be the best approach. HARI’s lobbyist has already contacted McBurney, she said, to start discussing how that would work.
Along with the state program, hospitals and Quality Partners of Rhode Island are already working to prevent surgical-site infections, she said, and hospitals are trying to join another program to reduce pneumonia and bloodstream infections.
HARI also has concerns with some of the details of McBurney’s bill, Duquette added, including how the data would be adjusted for risk, and how the state would ensure that all hospitals report their infections in the same way, so they can really be compared.
