Saving lives and the bottom line
Hospitals must answer growing pressure to act on homegrown
infections
By Betsy McCaughey
Story originally published
Every
day in hospitals across the
Infections that have been nearly eradicated in some countries are raging through American hospitals. The danger is worsening, because, increasingly, these infections cannot be cured with commonly used antibiotics. In 1974, 2% of staphylococcus aureus infections were methicillin-resistant. By 2003, that rate had soared to an alarming 57%, and it's still rising.
A few hospitals in the U.S.-too few-are proving these precautions work here,
too. The University of Virginia Medical Center,
Veterans Affairs Pittsburgh Health System,
We have the knowledge to prevent infection. What has been lacking is the will. Most hospitals have not made preventing infection a top priority. The federal Centers for Disease Control and Prevention is also to blame. The CDC has tracked the rapid rise in drug-resistant hospital infections for a quarter century, but hasn't advocated the rigorous precautions that can stop them.
Numerous studies demonstrate that bacteria spread from patient to patient as much as 15 times faster under standard CDC precautions as under the more rigorous precautions used in Denmark, Finland, Holland and the few hospitals here that are eradicating infection. Yet still, the CDC delays calling on all hospitals to implement these rigorous precautions, costing thousands of needless deaths and billions of dollars.
Can hospitals afford to take these more rigorous precautions? They can't afford not to.
Infections erode hospital profits, because rarely are hospitals paid fully
for the added weeks or months of care when patients get infections. For
example,
Similarly, a woman came into the hospital for stomach-reduction surgery, a procedure that should have produced a $9,900 gross profit for the hospital. But when she developed a central line-associated bloodstream infection and had to spend 47 days in the hospital, that profit turned into a $16,000 loss.
Allegheny reduced central-line-associated bloodstream infections by 90% and deaths from them by 95%, saving $1.4 million the first year.
Nosocomial infections cost hospitals more than $30 billion annually. Where does that figure come from? Two million infections per year times the $15,000 average additional hospital cost of treating an infection.
If cost is not enough to motivate hospital executives and board members to reduce infections, they now face three other pressures. The first is from trial lawyers. Remember asbestos? Hospital infection is the next asbestos. The infection problem has all the hot-button essentials of a successful class-action lawsuit: 2 million helpless victims per year, copious evidence that infections are preventable and a consistent pattern of failure to act.
The second pressure is public disclosure. Hospitals in many states will soon
be compelled to come clean about their infection rates. Six states-
Finally, shoddy infection control is poor preparation for an avian flu epidemic and poor homeland security. How can hospitals that lack the discipline and staff training to stop ordinary bacterial infections from spreading from patient to patient by touch possibly contain avian flu, which can be spread not only by touch but also by droplets when patients sneeze or cough? How can these hospitals contain a bioterrorism pathogen such as smallpox, which can spread invisibly in the air?
One of the best steps hospitals can take to prepare for these possible crises is to improve day-to-day infection control by adopting the more rigorous precautions advocated by the Committee to Reduce Infection Deaths and described in Unnecessary Deaths.
Every day you hear about health problems such as the uninsured. The
Betsy McCaughey is chairwoman of the Committee to Reduce Infection Deaths,