Activist pushes for access to hospital infection rates

In 2002, with data supplied by the British National Health Service, newspapers in England began publishing the names of hospitals with high infection rates. By 2004, every hospital in Great Britain was required to display its infection rate in a prominent place where patients could see it.

While that is not likely to happen in the United States any time soon, the pressure is on to make information on hospital infection rates more accessible to the public. For its part. the Centers for Disease Control & Prevention is turning up the heat by issuing recommendations to state health departments that are considering mandatory reporting of healthcare-associated infections. In the case of one prominent political figure, the fight to reduce hospital infection rates has become a full-time job.

Former New York State Lieutenant Governor Betsy McCaughey, Ph.D., is on a crusade to reduce hospital infection rates by changing not only the behavior of healthcare professionals but also common procedures and practices that contribute to the spread of infection.

"What I'm calling for is a revolution in the way medicine is practiced and taught and making hygiene and cleanliness central parts of medical care again as they were 50 years ago before the liberal use of antibiotics," McCaughey said at a press conference at the Harvard Club in New York City recently. McCaughey cited various reports, including CDC data that revealed hospital infections kill an estimated 103,000 Americans annually. That exceeds deaths attributable to AIDS, breast cancer, and automobile accidents combined. Beyond the human toll, the economic costs related to hospital infections are staggering. For instance, a serious bloodstream infection can add as much as $57,000 to a patient's hospital bill.

A simple preventative measure such as hand washing is one of the most effective ways to reduce hospital infections. Improvements in IV catheter use and compliance with presurgical best practices also reduce the opportunity for infection. Even wiping a stethoscope with alcohol before using it on a patient can pre-vent the spread of dangerous bacteria. McCaughey noted that the United States lags behind other countries in the preven-tion of one of the most deadly hospital infections, methicillin-resistant Staphylococcus aureus (MRSA), which is spread primarily by unclean hands and contaminated equipment.

McCaughey pointed to a culture of secrecy that she believes is partly responsible for the limited access the public has to data on infection rates. Although 21 states collect data on infections that lead to death or serious injury, the information is not released to the public. McCaughey lays blame on a powerful hospital lobby. However, the hospital industry argues that infection rates vary between hospitals. Facilities that treat AIDS, cancer, transplant, and immunosuppressive patients contend that it's unfair to compare their infection rates with hospitals that treat a healthier patient population. However, McCaughey said that data for those hospitals could be risk-adjusted to make comparisons fair. "What's unfair is keeping the public uninformed. If you go to the hospital for surgery, you should be able to find out which hospital in your area has an infection problem," said McCaughey.

"We have the knowledge to prevent these infections," said McCaughey. "No scientific breakthrough is needed."