Statement for the Record
by
The Hospital & Healthsystem Association of Pennsylvania
Oversight and Investigations Subcommittee,
Energy and Commerce Committee
March 29, 2006
Public Reporting of Hospital-Acquired Infections Rates:
Empowering Patients, Saving Lives
The Hospital & Healthsystem Association of Pennsylvania (HAP) represents nearly
250 Pennsylvania acute and specialty care, primary care, sub-acute care,
long-term care, home health, and hospice providers, as well as the patients and
communities they serve.
Pennsylvania hospitals recognize that preventing healthcare-acquired infections
is a major public health imperative. Patients who acquire infections in a
health care setting require more services and suffer additional consequences.
Patients who require a central line or a ventilator in their treatment are far
sicker and will always be more costly to treat, even if they do not contract an
infection. Solving the problem of infections in health care requires the best
efforts of doctors, nurses, regulators, insurers, patients, and their
families—all working toward a common goal to reduce and prevent infections.
Hospitals in Pennsylvania have a long history of public reporting of quality
and financial data and believe such reporting is important in demonstrating
accountability for the quality of health care provided to patients in hospitals
and other health care settings. We support the collection and public reporting
of healthcare-acquired infection information that is useful for patients and
purchasers of health care and is actionable by doctors and nurses in improving
the quality and safety of care.
Infection is an inherent challenge in all health care settings and solutions
must be based on good science and sound data. The Centers for Disease Control
and Prevention (CDC) has developed the National Healthcare Safety Network,
which uses clinical standards and methodologies. Pennsylvania hospitals are
participating in the CDC network and believe that expanding the network will
enable the use of consistent requirements and scientifically sound
methodologies across the country. HAP believes the Centers for Disease Control
and Prevention, working with other national organizations, such as the National
Quality Forum, the Joint Commission on Accreditation of Healthcare
Organizations, the American Hospital Association, and others can take a
leadership role in developing consistent reporting approaches across all
states.
The current methodology being used in Pennsylvania by the Pennsylvania Health
Care Cost Containment Council to collect and report infection data should not
be replicated across the country as it is not able to distinguish the actual
impact of infections on hospital days, mortality and morbidity, or payments,
and will not provide patients with useful information relevant to their
diagnoses nor be helpful to doctors and nurses working to eliminate infections.
Collecting data for the sake of collecting data is not what is needed; rather
state and federal agencies should be collecting data to turn into information
that can be used by doctors and nurses to correct problems. Sharing this
information and clinical methods to reduce and prevent infections is essential.
That is why the CDC’s National Healthcare Safety Network should be expanded and
why Pennsylvania hospitals will be working to do so.
PA Initiatives to Address Hospital-Acquired Infections
Pennsylvania hospitals want to achieve as much as possible in reducing
healthcare-acquired infections through programs to identify, control exposure,
and minimize risk to patients; and hospitals are involved in local, regional,
state, and national initiatives to make care safer.
These initiatives are achieving success and include:
• The Institute for Healthcare Improvement’s 100,000 Lives Campaign in which
more than 120 Pennsylvania hospitals are participating in the programs to
prevent and reduce central line associated bloodstream infections and
ventilator associated pneumonias. In Pennsylvania, HAP, regional hospital
councils, the state’s Patient Safety Authority, VHA, and groups representing
physicians and nurses are collaborating to bring best practices to hospitals
across the state.
• The Pittsburgh Regional Health Initiative’s efforts in southwestern
Pennsylvania, whose successful efforts over a four year period to reduce
central line associated bloodstream infections were reported in the CDC’s
October 14, 2005 Morbidity and Mortality Weekly Report.
• The Partnership for Patient Safety in southeastern Pennsylvania, a
collaboration of the Delaware Valley Healthcare Council of HAP and Independence
Blue Cross. This is a three-year initiative designed to enhance patient care at
southeastern Pennsylvania hospitals and is initially focused on identifying and
implementing best practice and evidence-based processes that will help reduce
hospital-acquired infections.
• The national Surgical Care Improvement Program, which is a national quality
partnership of organizations interested in improving surgical care by
significantly reducing surgical complications, including healthcare-acquired
infections.
Conclusion
The issue of preventing and reducing healthcare-acquired infections is
important. Hospitals cannot tackle this issue alone and there is a role for
everyone in making hospitals safer—including physicians, nurses, other health
care professionals, federal and state government, and patients. There is much
good work underway in Pennsylvania. Sound and scientifically accurate data will
help hospitals to evaluate successes and share best practices, and identify the
areas where there is still much to do.
National leadership, through the CDC and other organizations will ensure that
there is consistency and clinical validity to the data on healthcare-acquired
infections that is collected and publicly reported across the country.
Pennsylvania hospitals believe that good data, consistently reported by
hospitals across the country, will help patients and their families make
important health care decisions and will support hospitals, physicians, and
nurses in their efforts to prevent and reduce infections.
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Statement of the
American Hospital Association
before the
U.S. House of Representatives Committee on Energy and Commerce
Subcommittee on Oversight and Investigations Hearing
Public Reporting of “Hospital-Acquired Infections”
Empowering Consumers, Saving Lives
March 29, 2006
Controlling and preventing infections is a patient safety priority for America’s hospitals and permeates every aspect of hospital care. Hospitals understand that better, safer care, faster recovery, improved comfort for patients, and lower health care costs all come from reducing and preventing infections. A number of exciting initiatives are achieving remarkable results in reducing and preventing healthcare-associated infections (HAIs). We will provide important information on what HAIs are and what is being done every day in America’s hospitals to address them. In addition, we will describe our support for sharing meaningful information on HAIs with the public and how the American Hospital Association (AHA) is partnering with public and private organizations to make this happen.
BACKGROUND
The risk of infection from numerous sources threatens people every day. We are exposed to bacteria and viruses that cause colds, strep throat, ear infections or more serious infections such as sexually transmitted diseases or pneumonia. But in the health care setting, such as a doctor’s office, nursing home or hospital, the risk of infection is more acute for two key reasons: Patients’ immune systems may already be weakened by disease, injury or the medications and procedures being used to treat whatever has prompted them to seek care; and people may come into contact with others infected by more powerful viruses and bacteria.
Hospitals and clinicians understand that they must take action to ensure that the risk of infection is minimized, and they are taking precautionary steps that range from the routine sterilization of instruments to the use of specialized ventilation systems to reduce the chance of the airborne spread of germs. For effective strategies to prevent infections, hospitals look to the guidelines developed by the Centers for Disease Control and Prevention (CDC) and professional associations, such as the Association for Professionals in Infection Control and Epidemiology, the Society for Healthcare Epidemiology of America and the Infectious Diseases Society of America.
Many hospitals also have become involved in a variety of national and local efforts targeting infections, including the Surgical Care Improvement Project, the 100,000 Lives Campaign organized by the Institute for Healthcare Improvement, the Maryland Patient Safety Center, the Keystone Project of the Michigan Health & Hospital Association and other collaborative efforts. Each of these efforts emphasizes changing practices and procedures to adopt strategies shown to be effective in reducing infections. Such strategies include common sense precautions like hand washing, and changing care practices, such as appropriately timing the administration of an antibiotic so that it is received an hour before the start of a major surgery; keeping patients’ body temperature at a consistent level during certain surgeries, and several specific protocols for patients on ventilators. Many hospitals also are adopting highly sophisticated services, such as in-house genetics labs that allow staff to test specimens of bacteria and identify an organism's genetic "fingerprint" within hours so they can move more quickly to contain and eradicate infections.
In spite of these actions, the risk of infection can never totally be eliminated.
What is a healthcare-associated infection? Healthcare-associated infections – terminology adopted by the CDC – are generally defined as any infection that develops in a patient 48 hours or more after being seen in a health care setting. More specifically, it refers to an infection acquired in the setting in which health care was provided, which was not present or incubating at the time the patient was treated. “Hospital-acquired infection,” the term used by the Subcommittee in the title of today’s hearing, is a subset of this broader issue.
Occurrence rate. HAIs can occur within any health care setting. In hospitals, the greatest risk for infections is found among post-surgical patients, intensive care unit (ICU) patients and patients with serious diseases, such as HIV and cancer. It is estimated that between 5 percent and 10 percent of hospitalized patients in the U.S. will experience an HAI. Similar rates are seen in Australia and most European countries. Infection rates for long-term care facilities are estimated to range from 1 percent to 14 percent. While HAIs occur in all health care settings, we are unaware of reliable data for infection rates for ambulatory surgery centers, physician offices or other health care settings.
It also is important to note that not all infections are the same. Some, such as blood stream infections, are particularly dangerous, while urinary tract infections are less likely to lead to long-lasting harm for the patient.
Making matters more complex, several new strains of bacteria have emerged that are resistant to the usual antibiotics available to clinicians and are therefore particularly difficult to combat. Hospitals and other health care organizations are taking steps to reduce the development of antibiotic resistance, particularly with surgical wound infections, by monitoring when antibiotics are instituted, whether they are the right antibiotics to be used in either preventing or treating an infection, and by having those antibiotics discontinued at the appropriate time so that overuse does not lead to resistance.
Existing regulation of HAIs. Health care organizations are regulated by many agencies at the state and federal levels, such as Medicare and Medicaid. In addition, approximately 80 percent of hospitals, which represent about 95 percent of hospital beds in the United States, are accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Each government agency and the JCAHO have infection regulations that an organization must comply with in order to be licensed and/or accredited.
- Every hospital treating Medicare patients must have an active program for the prevention, control and investigation of infections and communicable diseases.
- Every hospital that is accredited by the JCAHO must have a program for reporting infection surveillance, prevention and control. They also must have an infection control officer in place.
- Three types of surveillance can be used by a health care organization:
- Hospital-wide or “active” – provides data on all infection sites/units.
- Targeted surveillance – provides data on specific infections/units.
- Objective/priority-based – focuses on specific institutional problems.
- Staffing – The general recommendation is one infection control practitioner (often a nurse) to 250 beds, but many hospitals have one practitioner to 125 beds.
REPORTING
It has been difficult to find measures that will lead to meaningful, accurate information for the public about HAIs. In fact, the CDC’s Healthcare Infection Control Practices Advisory Committee has concluded that there is insufficient evidence to recommend for or against public reporting of HAIs. Some professional organizations have issued guidance concerning how infection rates should be reported. According to infection control experts such as the Association for Professionals in Infection Control and Epidemiology and the Society for Healthcare Epidemiology of America, an infection rate must be calculated based on a standardized process. It must specify which type of patient is to be sampled; how patients will be identified; against what measures patients will be evaluated; and how infections will be defined and reported. A lack of a clear methodology and standardized definitions and procedures could result in inaccurate reporting of infection rates.
Just last year, Congress enacted federal legislation that created a framework and process for reporting medical errors, of which HAIs are one. The Patient Safety and Quality Improvement Act of 2005 (P.L. 109-41) is a milestone. It will allow hospitals, physicians and other health care providers to voluntarily report medical errors as well as other events that did not – but could have – resulted in a medical error in a manner that is legally privileged and confidential. As a result, this law is much more likely to encourage such reporting and to help establish within health care a “culture of safety.” Reports made under the law to Patient Safety Organizations allow experts to analyze problems, share recommended solutions and advance patient safety. The legislation will facilitate the sharing of infection-related data and best preventative practices.
AHA VIEW
The AHA supports sharing information about healthcare-associated infections with the public. That information must be meaningful for consumers and must:
• be based on solid data and good measures (see Attachment A for AHA’s Principles of Quality Measures);
• target infections that have the highest potential for greatest harm; and
• focus on areas where clinically proven prevention efforts exist.
The AHA supports voluntary reporting of HAI-related information through the Hospital Quality Alliance (HQA). The HQA is a public-private partnership of hospitals, consumer groups, clinicians and the government formed to collect and report agreed-upon hospital quality measures to the public. The HQA is made up of government agencies, including the Centers for Medicare & Medicaid Services (CMS) and the Agency for Healthcare Research and Quality (AHRQ); professional organizations, such as the AHA, American Medical Association, American Nurses Association, Association of American Medical Colleges, Federation of American Hospitals, JCAHO, National Association of Children’s Hospitals and Related Institutions, National Quality Forum (NQF) and U.S. Chamber; and consumer organizations such as, AARP, AFL-CIO and the Consumer-Purchaser Disclosure Project.
Specifically, the AHA supports voluntary reporting through the HQA of surgical infection prevention measures, surgical wound infection rates and central line blood stream infection rates. Further, the HQA is working to make data on these measures public.
• Surgical infection prevention measures. More than 1,300 hospitals are already sharing comparable information on infection prevention measures on the HQA’s Web site, www.HospitalCompare.hhs.gov. Others are in the process of beginning to collect and share this data, so the number of hospitals reporting these measures will increase over time.
• Surgical wound infection rates. The HQA, as a part of its agreement to adopt the Surgical Care Improvement Project (SCIP) measures, will consider adding surgical wound infection rates as soon as the technical specifications are finalized by SCIP. A national quality partnership, SCIP’s goal is to reduce the most common surgical complications, including surgical wound infections and pneumonia, by 25 percent by 2010. The SCIP Steering Committee is comprised of 10 national organizations including the AHRQ, American College of Surgeons, CDC, CMS, Institute for Healthcare Improvement (IHI), and AHA among others.
• Central line blood stream infection rates. Hospitals have not yet been asked to submit these data because the measures are undergoing review as part of the NQF’s consensus process. Once adopted as an NQF-endorsed standard measure, the HQA will move forward to collect and report data on these measures.
Hospitals are working hard to improve the quality and safety of patient care. In fact, hospitals and health systems across America are involved in several exciting initiatives in which they are achieving remarkable results in reducing and preventing HAIs. Here are a few examples:
• The Michigan Health & Hospital Association’s Keystone Project, working with the Johns Hopkins University, has achieved significant, measurable improvements in reducing HAIs. Of the 127 ICUs participating, 68 have reported zero blood stream infections or ventilator-associated pneumonia for six months or more.
• In 2004, the Maryland Patient Safety Center, a partnership of the Maryland Hospital Association and Delmarva Foundation, set out to improve care in the ICU. Using evidence-based protocols, the collaborative saw the rate of preventable catheter-related blood stream infections reduced by 36 percent and ventilator-associated pneumonia drop by nearly 20 percent within nine months.
• Through the IHI’s 100,000 Lives Campaign more than 3,000 hospitals are implementing one or more evidence-based interventions and establishing new standards of care. For example, a consortium of 23 well-respected teaching hospitals in New Jersey have reduced their blood stream infection rates by 50 percent, and in their ICUs, the rate of ventilator-associated pneumonia has been reduced by 75 percent over a nine-month period. In addition, 14 other hospitals have had no cases of ventilator-associated pneumonia for one year or more. Further, participants in IHI’s collaboratives to prevent surgical site infections and central line infections have seen their infection rates plummet, often to zero.
Finally, the CDC is an essential partner in hospitals’ efforts to fight HAIs. As such, we are concerned over the proposed cuts to the CDC that are included in the Administration’s budget proposal for fiscal year 2007. Some reports estimate the cuts to be as deep as 8 percent over two years.
CONCLUSION
Hospitals work every day, in conjunction with physicians, nurses and other hospital staff, to provide the best possible care for their patients. This includes battling all infections, regardless of their origination, as well as stepping up efforts to ensure that the delivery of care itself does not spread infection. It also includes efforts to tackle infections that continue to grow resistant to available antibiotics. Equally important, hospitals are committed to providing consumers with meaningful information that will allow them to make informed health care decisions.
Voluntary efforts, such as those found in the Patient Safety and Quality Improvement Act of 2005 and the HQA and its Hospital Compare Web site, will produce the most meaningful information, lead to a focus on infection prevention and ultimately lead to increased improvements in quality of care. The AHA will continue collaborating with the CMS, AHRQ, CDC and others to help hospitals provide the safest, most effective care possible. We also welcome the opportunity to work with members of the Subcommittee on this important issue.
Attachment A
AHA Principles of Quality Measures
Assessing and improving the quality of health care services is one of the most important functions of our health care system. Health care providers must rely on sound data as they strive to continuously improve patient care. In addition, quality information is needed to assure and inform consumers who are choosing health care providers and making treatment decisions. In order to meet these goals, certain principles need to guide the development of quality measures:
- Quality measures must be data based, scientifically driven, and should produce consistent and credible results.
- Quality measures should be valid, reliable, precise and meaningful.
- Quality measurement should include structure, process and outcome measures.
- Quality measurement activities should stimulate improvement and learning, support effective staff practices, and be conducted in a non-punitive, blame-free manner.
- Health care organizations, physicians and other caregivers should work collaboratively to implement a set of quality measures that are prioritized and trended over time, with formal processes in place to improve performance and reduce variation.
- Methodologies used to create quality measures must be shared publicly to ensure the integrity and enhanced understanding of reported data.
- Quality measurement should seek to reduce burden, increase uniformity and increase comparability.
- Quality measures should demonstrate value and cost-effectiveness.
Top of page
HEARING BEFORE THE
UNITED STATES HOUSE OF REPRESENTATIVES
COMMITTEE ON ENERGY AND COMMERCE
TESTIMONY OF
MARC P. VOLAVKA
EXECUTIVE DIRECTOR
PENNSYLVANIA HEALTH CARE COST CONTAINMENT COUNCIL
ON
MARCH 29, 2006
Summary of Remarks by
Marc P. Volavka
Executive Director
Pennsylvania Health Care Cost Containment Council
Before the
U.S. House of Representatives
Committee on Energy and Commerce
March 29, 2006
- Pennsylvania began collecting data on
hospital-acquired infections in January 2004. Almost every state has the capability to establish a reporting system based on
Pennsylvania’s
model.
- The Pennsylvania Health Care Cost Containment Council
(PHC4) has found that the patient safety and
financial impact of hospital-acquired infections is larger than originally
reported. During the
first nine months of 2005, Pennsylvania hospitals confirmed more
hospital-acquired infections than for all 12 months of 2004.
- Hospital-acquired infections are deadly. You are over five times more likely to
die during a hospital admission in which you acquire an infection than if
you don’t.
- The costs of hospital-acquired infections are staggering. Payment
data suggests that, on average for
commercially-insured patients, there was a $52,600 difference between
hospital admissions in which the patient acquired a hospital-acquired
infection and one in which the patient did not.
- Hospital-acquired infections are not inevitable, nor should they
be expected. Simple and effective
methods, such as hand washing, using gloves, and properly sterilizing
equipment, can dramatically reduce and/or eliminate hospital-acquired
infections.
- We cannot
improve what we do not
measure. Requiring the
collection and publicly reporting of data are
two steps in measuring the extent of the problem and identifying
solutions.
- Don’t let the perfect be the enemy of the good. When it comes to data collection and
reporting on hospital-acquired infections, the data need not be
perfect. In fact, we ultimately
need to find ways to get infection control professionals out of the data
collection business and into the business of finding and preventing
hospital-acquired infections.
Mr.
Chairman and Members of the Committee:
Good afternoon, my name is Marc P. Volavka, and I am
the Executive Director of the Pennsylvania Health Care Cost Containment
Council. I am honored to have the
opportunity to address this Committee today and to talk about the importance of
publicly reporting hospital-acquired infections.
Last summer, the Pennsylvania Health Care Cost
Containment Council – often referred to by its acronym, PHC4 – issued a
landmark report on hospital-acquired infections. Thus, Pennsylvania
became the first state in the nation to put some hard figures around the
incredible burden of these infections.
While we expected to receive some attention, we were,
quite frankly, astounded by the firestorm of debate that tiny, four-page report
caused. Since our first report, PHC4 has
issued two additional briefs on hospital-acquired infections, one of which has
just been released today.
Data Collection and Reporting in Pennsylvania
I thought I should begin by giving some background on
Pennsylvania’s data collection
process. I also think it is important to
set the record straight about what PHC4 did and did not report in our
groundbreaking Research Brief. First and
foremost, despite what some have said, we did not use “billing data” to
identify hospital-acquired infections.
The infections listed in our reports were identified, submitted and
confirmed by Pennsylvania
hospitals.
To define hospital-acquired infection, PHC4 adopted,
with minor clarifications, the Centers for Disease Control and Prevention (CDC)
definition: an infection is a
localized or systemic condition that 1) results from adverse reaction to the
presence of an infectious agent(s) or its toxin(s) and 2) was not present or
incubating at the time of admission to the
hospital. Essentially, what this means is: you didn’t come in with
it, and you got it in the hospital.
Frankly, this is not a difficult concept to grasp.
PHC4 also adopted the CDC’s 13 major site categories
that define the hospital-acquired infection location, and expanded the list of
13 to include a category for multiple infections and to differentiate device
related and non-device related infections.
We then redefined a two-character data field (Field 21d) on the Pennsylvania Uniform Claims and Billing Form,
which is submitted along with administrative and billing data for each
inpatient hospital admission. Hospital
personnel enter one of a defined set of codes into this field when the relevant
hospital-acquired infection is present.
Almost every state in the nation is already positioned to use the
uniform billing form in a similar manner.
In Pennsylvania,
data collection began in January 2004, and hospitals were required to submit
data to PHC4 on four types of hospital-acquired infections: surgical site,
urinary tract, pneumonia, and bloodstream infections. The data collection requirements were
gradually expanded over a period of several quarters, and as of January 2006, Pennsylvania
hospitals are now required to submit data on all hospital-acquired
infections.
So what did PHC4’s first report on hospital-acquired
infections reveal? In 2004, Pennsylvania hospitals confirmed 11,668
hospital-acquired infections. The hospital admissions in which these infections occurred were associated with an additional 1,510 deaths, 205,000 extra days of hospitalization and $2 billion in additional hospital charges. While these numbers are certainly
shocking, what is chilling is that the figures were underreported – just the
tip of the iceberg. PHC4’s most recent
report released today, which looks at only the first three quarters of 2005, underscores that the
problem of hospital-acquired infections is larger and more costly than
originally estimated. It also highlights
the difficulty in getting a standard, consistent and understandable form and
format to identify and collect this information.
During
the first nine months of 2005, Pennsylvania hospitals confirmed and reported
14,526 hospital-acquired infections. If the reporting trend continues for
fourth quarter, we will approach 20,000 identified HAI’s for all of 2005.
13,711 of the 14,526 are identical to the 4
categories that were confirmed and reported in 2004 -- the 11,668 figure. The hospital admissions in which these 13,711
infections occurred were associated with an additional 1,456 deaths,
227,000 extra hospital days and $2.3 billion in additional
hospital charges.
Hospital-acquired Infections Are Deadly
While I think all of this
background is important, there are really six key points I would like to make
today based on Pennsylvania’s public reporting experience. The first, and perhaps most compelling, is
that hospital-acquired infections are
deadly.
As I previously mentioned,
based on only nine months of 2005 data
from Pennsylvania hospitals, the hospitalizations with
hospital-acquired infections were associated with 1,456 additional deaths. Extrapolated nationally, this translates to
almost 40,000 additional deaths annually. That’s approximately 110 people per day dying
nationally. If 110 people were dying
daily from the Bird Flu, I think we’d be calling that an epidemic.
While I hate to throw out
too many numbers because real people and real lives are at the heart of this
issue, a comparison of the mortality rates of patients with and without
hospital-acquired infections is also eye-opening. Of the 13,711 Pennsylvania patients with a hospital-acquired infection in first nine
months of 2005, 13 percent died, compared to 2.4 percent of patients who did
not contract such an infection. What
that means is, you are over five times MORE likely to die during a hospitalization
if you get an infection, than if you don’t.
Those aren’t good odds.
The Costs of
Hospital-acquired Infections Are Staggering
Just as hospital-acquired
infections are a major patient safety issue, their financial implications are
staggering, which brings me to my second point.
The cost of hospital-acquired infections continues to place an already
financially shaky health care system at greater jeopardy. Through insurance premiums and tax dollars,
Americans are spending
exorbitant amounts of money on these infections, which are, in almost all
instances, preventable.
Again, based on only nine months of 2005 data, the hospital admissions in which these infections
occurred were associated with $2.3 billion in additional hospital charges, just
in Pennsylvania.
Extrapolated nationally, the total would reach $46 billion.
As our
research brief issued today identifies, Pennsylvania has also become the first state in the
nation to put hard numbers around actual payments. Pennsylvania received actual payment data from
third-party commercial insurers and matched it to the hospitalizations for 2004
in which the reported hospital-acquired infections occurred. In 2004, the average payment – that is the
actual payment, not charge – for a hospitalization with a hospital-acquired
infection was $60,678. The
average payment for a hospitalization without a hospital-acquired infection was
$8,078.
This data shows that, on average, there was a $52,600
payment difference between hospital admissions with and without a
hospital-acquired infection. As a
result, we estimate additional insurance payments to Pennsylvania
hospitals from the private sector, Medicare and Medicaid at $613.7 million for
the 11,668 hospital-acquired infection cases
in 2004. To extrapolate for all of 2005,
with the assumption that payments did not change at all (not a solid
assumption) we estimate that payments made to hospitals for patients who get a
hospital-acquired infection will be over $1.2 billion in Pennsylvania
alone. That would be $24 billion in
payments nationally. And, this is only
the hospital portion of the payment. It
does not include the additional physician payments, or the ongoing care many of
those patients need, if they are the lucky ones who survive the infection.
This is a major
concern to Pennsylvania
businesses and labor unions that pay insurance premiums through the commercial
market and to public sector programs. It also contradicts those who say there is no low-hanging fruit in health-care cost savings left to find.
Now, as compelling as these numbers are for
the health care purchasers paying the tab, there is an equally compelling
business case for hospitals to prevent hospital-acquired infections. While hospitals get paid, on average, seven
times more for a patient that acquires an infection, work done by Dr. Richard
Shannon, under the auspices of the Pittsburgh Regional Healthcare Initiative,
and continued by others, indicates that the cost of treating these infections
far exceeds the extra payment received.
I believe Dr. Shannon will testify more on this point, so I will leave
that to him.
Hospital-acquired Infections Are Not Inevitable
With patients, payers and providers all losing out,
it is hard to understand why there is still so much debate surrounding my third
point. Hospital-acquired infections are not inevitable, nor should they be
expected. These infections can be
prevented. For years, there has been this so-called
myth of inevitability – that is, hospital-acquired infections are the inevitable
byproducts of providing hospital-based care.
This myth has persisted despite the fact that simple and effective
methods, such as hand washing, using gloves and properly sterilizing equipment,
can dramatically reduce the incidence of hospital-acquired infections.
Too often, blaming “inevitability”, instead of
identifying and correcting poor processes of care, is the norm. Hospital-acquired infections should not be
about placing blame or fault, with either patients or providers. However, they also should not be about
masking their existence behind statistical methodologies like “infections/1000
line days” and language like “nosocomial” that only the “experts” could
understand or explain. When talking
about hospitals, if you didn’t come in with it, and you got it in the hospital,
to me, that’s a hospital-acquired infection.
The new
moniker; “healthcare-associated infections”, concerns me, because it has the
potential to blur and soften the implications of, and the solutions for,
infections acquired while hospitalized.
We Cannot Improve
What We Do Not Measure
Of course, finding solutions is ultimately what we
should be about. That is why PHC4 has a
history of public reporting. We cannot
bring attention to problems that see no light.
We cannot improve what we do not
measure.
Obviously, not all of the
feedback PHC4 has received with respect to its publicly reporting
hospital-acquired infections has been positive.
One of the criticisms we have received is that our public reporting
about this deadly issue does not help to improve care. In fact, we have heard over and over again
from industry officials that reporting infection rates is not the same as reducing
infections. Well, on that point, I
agree. But, if you don’t collect data,
you can’t identify the problem; and if there is no public accountability, where
is the incentive to provide solutions?
After
PHC4’s first report was issued, one of our critics said, “There is no evidence
to support the public disclosure as a means to reduce the incidence of these
infections.” My response to was that he
was only half right.
There
is no evidence to support public disclosure because public disclosure of hospital-acquired infections has never been done –
until now.
We
have also been cautioned about the potential consequences of mandatory
reporting for hospital-acquired infections.
It has been argued that such mandatory reporting may deflect resources
from patient care and prevention, mislead stakeholders if inaccurate data is
published, and cause some physicians to avoid treating sicker patients. This theme – “the unintended consequences of
public reporting” – has been repeated in the recent literature on public
reporting.
Let me address this issue head on.
First, while there may not be any evidence yet that
public reporting DOES help reduce the incidence of hospital-acquired
infections, I would humbly suggest there is ample evidence that the way we have
been doing business over the past 30 plus years, which has relied heavily on
private, voluntary, non-public collection and analysis of data by the CDC is
NOT working.
In an article published in the New England Journal
of Medicine in 2003 they reported that nationally between 1975 and 1995:
- The
number of patient days decreased by 36.5%
- Lengths
of stay decreased by 32.9%
- The
number of inpatient surgical procedures decreased by 27.3%
- The
number of infections decreased by 9.5%
However:
- The
incidence of nosocomial infections per 1,000 bed days increased by 36.1%
(New England Journal of Medicine, 348:7, 2003)
It was these
statistics that caused the Journal to
publish the following remarks in its editorial:
“If collecting data in
isolated hospital areas represents “best practice” when 2 million Americans
develop a hospital-acquired infection, resulting in 90,000 deaths, and $5
billion in cost, then best is just not good enough.” (New
England Journal of Medicine, 348:7,
2003).
To echo the title of today’s hearing, PHC4 believes
that public reporting IS about saving lives and money by
empowering consumers and purchasers of health care benefits. Public reporting is the first step in measuring the extent of the problem
and the effectiveness of solutions implemented.
Public reporting changes behavior. The best scientific evidence of this is the
most recent study done by Dr. Judith Hibbard, and published in the July/August
2005 issue of Health Affairs, indicating that hospitals that were
publicly reported on in Wisconsin had significant quality improvement the
following year – while those that were NOT publicly reported on, and that had
only private feedback, or no feedback at all, showed little, if any,
improvement.
And with respect to
hospital-acquired infections, PHC4 believes that by providing objective,
comparative data to the public, both patients and third-party payors can make
more informed decisions about choosing a hospital and
our hospitals themselves, with heightened awareness of the seriousness of this
issue, and with the potential for public accountability, will more rapidly
implement better and more contemporary infection control practices.
PHC4 works under the philosophy that the public
reporting of health care data is the policy approach that saves the most lives
and best stimulates quality improvement.
This philosophy is, in fact, consistent with the Administration’s
current goal of increased health care price and
quality transparency. And the
case for public reporting can be made by several PHC4 achievements. For example, since PHC4 began publicly
reporting patient mortality rates for Pennsylvania
hospitals, these rates have dropped from significantly above the national
average in 1993 to significantly below the national average in 2003. Similarly, mortality rates for coronary
artery bypass graft surgery in Pennsylvania
have dropped 48% in the past ten years, mirroring the years of public reporting
by PHC4. And, Hannan, Chasen et al,
demonstrated that in the case of the two states that had been publicly
reporting on CABG mortality the longest, New York
and Pennsylvania, the decrease in
CABG mortality was significantly greater that that experienced across the
nation at large. (Medical
Care,
2003).
One of the other criticisms I would like to address
is the rhetoric of the “meaninglessness” of our data, perhaps best articulated
in an August 2005 Governing magazine
article:
“Put out these gross statistics and people get all
alarmed, but what are they going to do with this data? If you think hospitals
are going to scramble and fix it, then maybe, but I don’t think that’s what
will happen. I think they will look at the data and call it what it is —
meaningless.”
Meaningless? To whom?
The following letter
to the editor appeared in the July 29, 2005 issue of the Pittsburgh
Post Gazette:
I was interested in reading about
hospitals and infections (“Alarms
Raised on Hospital Infections,” July 12). My
husband went into one of the large hospitals in the Pittsburgh area for a heart catheterization and
was told he needed open-heart surgery. I spoke with the surgeon after the
operation and was told that the operation was a success. After about four days
of intensive care, I saw a new bag hanging beside the bed and asked why and
what for. I was told he had an infection and needed an antibiotic. I asked how
did he get an infection. The reply was "Everyone thinks that hospitals are
the cleanest places in the world, but they are not." My husband died on
the 12th day in the intensive care unit. Remember the old saying, "The
operation was a success, but the patient died"? How true.”
ELINOR ROGERS McGINN
Churchill
J
And,
on July
18, 2005, Frederick K. Miller
said:
“I am glad to see a state agency doing its job! My wife had three operations. The Dr. did not address her infection for a
year after surgery. She got the
infection at a local hospital. There is
a low staff of nurses. I had several
relatives get an infection at the same hospital. One of them died.”
While I take issue
with the notion that our data is meaningless, I am cognizant of the fact that
the data on hospital-acquired infections needs to be improved, and made both
meaningful and actionable.
And, with all due
respect and deference to the CDC, what is currently viewed as the national
standard for gathering information on hospital-acquired infections – the
National Nosocomial Infections Surveillance System (NNIS) and the definitions
and guidelines that it uses – does not meet the mark. This voluntary system has
operated for over 30 years, involves data collection which is not comprehensive,
consistent or comparative and, for the most part, is not publicly
available.
In a study of the
NNIS data collection/reporting, conducted by the Centers for Disease Control
and Prevention itself, and subsequently reported in a 1998 issue of Infection
Control and Epidemiology, three separate groups of infection control
experts reviewed 1136 patient charts in order to determine the consistency,
objectivity and credibility in using such a surveillance system for identifying
hospital-acquired infections. After a
review of the charts, results from abstracters at nine NNIS participating
hospitals indicated 611 infections were present. A second group of trained reviewers
evaluating those same patient charts found 474 out of those 611 infections reported
were in fact, hospital-acquired infections, but also found 790 additional
infections not reported by the hospital, for a total of 1264. Finally, in a review of the charts by CDC
personnel themselves, 525 out of the 611 were identified as hospital-acquired
infections with an additional 340 infections not reported for a total of 865
total infections.
The study, in my eyes, demonstrates that, a
voluntary, hospital-based reporting system used to monitor hospital-acquired
infections and guide the prevention efforts of infection control practitioners,
is neither objective, nor consistent; and brings all the biases that human
judgment and diffuse guidelines produce.
In today’s age of technology and the ability to electronically download
lab, pharmacy, and other vital clinical data, private companies like MedMined,
Theradoc, Cereplex, and others have already developed software tools that in a
far more automated way, detect and identify hospital-acquired infections. Just as it is with a patient’s medical record
and history, it’s time to let the paper and pen go.
Don’t Let the Perfect Be the Enemy of the
Good
I believe, to its credit, that the CDC will
acknowledge some of the shortcomings of the manner in which the NNIS database
was collected, and the problems with very complicated and often misinterpreted
definitions. While I believe it has been
problematic, I do not believe that the data needs to be perfect. That is why my fifth message is that we cannot let the perfect be the enemy of
the good. When it comes to data
collection and public reporting, we do not need pine needle detail, data
perfection or epidemiological purity to shine light on a problem. Those who argue about needing perfection
before we publicly report, miss both the light, and the point. Sometimes, sunshine is the best disinfectant!
In fact, we need to find ways to get some of the most
dedicated people I’ve met – the physicians in infectious disease and our
infection control professionals – out of the pine needles of manual data collection,
and onto the floors and into the rooms of hospitals, so they can do the job
they were trained for – finding and preventing the causes of the
hospital-acquired infections.
I also think
I can safely say that the pattern in Pennsylvania,
as well as in other states that embrace public reporting, is that once health
care data gets reported, the data gets better and so do the improvement
efforts.
States are the Incubators of Health Care
System Innovation
With that said, my final message today is that states have historically been, and continue
to be, the incubators for innovation and solutions, and, as such, their
role in transforming the nation’s health care system needs to be engaged, and
enlarged. In addition to shedding light
on the problem of hospital-acquired infections, Pennsylvania,
and others, have led the way in other efforts to promote greater transparency in health care through collecting and
reporting health care data. Florida,
Maine, New
York, Maryland, New
Jersey, and Virginia
are also laboratories of transparency, using different outcome measures and
different data collection methods, but all aimed at the same goal: greater public transparency on both quality
and cost.
In testifying before a U.S. Senate Committee two weeks
ago, Paul H. O’Neill said:
“Unfortunately, the federal government rarely
sets performance targets at all, let alone setting them at the theoretical
limit of human attainment. The result of not insisting on the elimination of
fundamental problems with the performance of the healthcare system is more of
the same, or worse. For example, there are clear reasons that the appalling
healthcare-acquired infection rate – affecting approximately 1 in 12 people
admitted to the hospital -- has been steady or increasing for decades.”
I
believe Mr. O’Neill was right. It’s time
to stop wringing our collective hands, and start washing them!
States need the flexibility, and the
Nation benefits, when states are encouraged to experiment with solutions that
may work toward a common goal, while recognizing the unique socio-economic and
political environment that varies dramatically amount the 50 states.
Rather than setting a single
standard on the “what’s and “how’s” of data collection, what Congress can best
do is establish performance targets and goals, and then provide incentives that
states can use, with flexibility, and, given their own limited resources, begin
to act on reducing and eliminating hospital-acquired infections.
If Congress said simply and
clearly: In five years, the goal of our
health care delivery system should be to eliminate all hospital-acquired
infections, and, in five years, Medicare will no longer pay for any
hospitalization in which a hospital acquired infection occurs; I humbly suggest
the goal of patient safety that we all share would be transformed into action
virtually overnight by our hospital and physician community.
There could be no more noble or
compelling issue for Congress, and our nation, to tackle.
While the public may not fully grasp
the nuances of a risk adjusted mortality rate, or how to decipher HEDIS
measures on appropriateness of preventive care outcomes, when it comes to
hospital-acquired infections, the public “gets it”! Hospital-acquired infections are bad. They don’t want one; they don’t want their
family or friends to get one; and they want to know, should they
have to be hospitalized, which hospitals in their area are doing the best to
prevent them.
In fact, what the public fully
“gets” is, they DON’T want to “get it”.
In Pennsylvania,
we’re doing our best to provide usable, actionable information to see that this
goal is achieved.
Mr. Chairman, on behalf of the
Council members that set our priorities and agenda, and with pride in the
dedicated and talented staff of PHC4, I thank you for the honor and the
privilege of testifying here today.
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