These facts underline the urgent need for all health facilities to adopt the best practices to stop the spread of germs—sanitizing rooms and equipment; washing hands thoroughly; inserting catheters in sterile conditions; monitoring for dangerous organisms; and taking special precautions with patients who carry them.
The proliferation of superbugs is a daunting problem, but one that has the attention of consumer advocates, insurers, federal and state governments, as well as hospitals and health care providers.
How to beat the superbugs:
Follow the money. Hospital-acquired infections cost an estimated $20 billion a year, according to the CDC, and a lot of human suffering. For example, the knee replacement Margaret Day, of Fort Lauderdale, Fla., had in 2006 would have been a great success—except for the C. diff infection that kept her in the hospital 20 days, some spent semiconscious in the ICU. This ordeal was not only costly for Medicare and the hospital, it also cost Day, an active 88-year-old, thousands of dollars a month in medicine and for help at home during her recovery.
On Oct. 1, Medicare stopped paying for complications arising from certain infections (but not C. diff) and conditions that result from hospital care and are “reasonably preventable.” The government wants hospitals to make safety measures job one, says Nancy Foster, vice president for quality and patient safety policy at the American Hospital Association. “Hospitals have heard that,” she says, and are adopting new strategies to protect patients.
Some private insurers, including CIGNA, WellPoint and United Healthcare, are following Medicare’s lead on not paying for medical errors in hospitals.
Name names. Consumer advocates say that public scrutiny can prod health facilities into action. “Hospitals begin to be more aware and evaluate their processes as soon as the state passes a law that says they’re going to have to report infection rates to the public,” says Lisa McGiffert, head of Consumers Union’s campaign against hospital infections.
To date, 25 states have done just that. The quality of data may vary from state to state and even facility to facility, but the first reports show that some hospitals are safer than others. [See “To Learn More.”]
Set an example. For years, hospitals have accepted certain kinds of infection as inevitable. One example: About 250,000 Americans a year get a bloodstream infection after having a catheter inserted into a large vein to give fluids or medications. Such infections have had a death rate as high as one in four. But last month, a CDC study in the Journal of the American Medical Association indicated that preventive measures had helped lower the rate of MRSA bloodstream infections by nearly 50 percent from 1997 to 2007, based on reports from 1,684 ICUs.
Certain hospitals are ahead of the game. With help from the CDC, 32 hospitals in southwestern Pennsylvania adopted a rigorous protocol and slashed the rate of bloodstream infections in their ICUs by 68 percent from 2001 to 2005. And 108 hospitals in Michigan in 2003 embarked on a voluntary program that virtually wiped out bloodstream infections.
Streamline for success. In March 2008 the U.S. Government Accountability Office reported that the government recommends 1,200 separate practices to prevent infection in hospitals, 500 of which are “strongly recommended.”
In October a consortium of leading health care professional societies, the American Hospital Association and the Joint Commission, an agency that accredits hospitals, published a document boiling down the government verbiage into six strategies targeting major problems.
The Michigan program used an even simpler method to protect patients from infection. Doctors and nurses were required to follow a five-step checklist—washing hands, wearing sterile gowns and gloves, and protecting the patient with antiseptics and sterile drapes and dressings—developed by a Johns Hopkins University team of safety experts led by Peter Pronovost, M.D.