Enter at Your Own Risk

Knickerbocker

By Gary Shapiro

February 9, 2006

Hospital infection kills as many Americans annually as AIDS, breast cancer, and auto accidents combined, according to a former lieutenant governor of New York State, Betsy Mc-Caughey, the chairman of the Committee to Reduce Infection Deaths. Speaking at a reception Tuesday at the W. Graham Arader III Gallery of New York, she outlined her hopes for changing hospital practices in this country. "Unfortunately most hospitals have not made preventing infections a top priority," she said.

Hands, gloves, doctor's lab coats, nurses' uniforms, stethoscopes, and blood pressure cuffs can carry bacteria from patient to patient. She said teaching of hygiene is far less rigorous than it was 50 years ago - before the liberal use of antibiotics replaced attention to hygiene. "That's why RID was founded: to motivate hospitals to prevent infection and to give them a compelling economic rationale for doing so."

RID hosts forums for hospital executives, insurers, public health officials, patient advocates, and others. "When hospital administrators come and say, 'We can't afford to take these precautions,' we prove to them with the data that they can't afford not to take these precautions, because infections erode hospital profits."

Ms. McCaughey said that hospitals seldom get repaid for most of the cost of the additional length of stay after a patient develops an infection. She said studies show that the cost of gloves, gowns, and staff retraining repaid itself in the first year by as much as 10 to one and required no capital outlays. "So we can provide a compelling economic rationale to reduce infections."

Ms. McCaughey also said that RID provides information for patients on how to protect themselves from in fection in hospitals.

She held up a flier that offered tips such as "Ask that hospital staff clean their hands before treating you.If you're worried about being too aggressive, just remember that your life could be at stake." Also, "Don't be falsely reassured because caregivers are wearing gloves. Gloves more often protect staff than patients and can spread germs once they are contaminated."

The audience applauded when Ms. McCaughey said that several large insurers are actually paying RID for the privilege of distributing such information to subscribers.

On the positive side, Ms. McCaughey described some successes at improving hygiene and drastically reducing drug-resistant infections. She said the University of Virginia, the University of Pittsburgh, and Allegheny Hospital in Pittsburgh have made serious strides toward reducing hospital infections. Abroad, hospitals in Denmark, Holland, and Finland have very high cleanliness standards.

Several in the audience described having lost loved ones to hospital infection. Art teacher Patricia Moore's 28-year-old son died in 2002 after undergoing surgery on his windpipe. He had become infected with Methicillin Resistant Staphylococcus Aureus (MRSA).

"It need not be this way," said Ms. Mc-Caughey's former high school roommate, Jo Shields,who lost her husband after he entered a hospital for complications from Parkinson's disease.

Robert Solomon, a clinical social worker who teaches in the mental health program at Touro College, lost his mother 10 months ago from a hospital related infection. Also present was Maureen Daly, whose mother died at age 64 after entering a hospital with a broken shoulder.

Dr. Howard Bellin said there were historical precedents to RID's work, referring to Ignaz Semmelweis, who discovered that washing hands reduced the number of women who contracted puerperal fever after giving birth.

Ms. McCaughey said that RID scored a victory for New York last year when the state Legislature passed a bill for risk adjusted hospital infection report cards: "For too long, secrecy has allowed the hospital infection problem to fester. But in the future, you'll be able to go on a Web site and look up in your area which hospital has the worst infection problem so you can stay away."

In attendance was Dr. Barbara Gordon who noted that years ago doctors received freshly laundered white uniforms every day.

Ms. McCaughey said that a former chief of staff and medical director of NewYork-Presbyterian Hospital, Dr. Allen Hyman, had joined the committee. The evening honored two committee members: Charles Brunie, an investor in this newspaper; and a manufacturer and marketer of food products, Donald Tober, who likened Ms. McCaughey to a saint, humorously calling her the "Mother Seton" of cleanliness.