Deaths drive call for cure

Ex-lieutenant governor leads group urging cleaner practices at hospitals to fight germs

First published: Friday, April 8, 2005

ALBANY -- Pat Moore's 28-year-old son, Brad, went into an Orange County hospital with a head injury after he was mugged nearly three years ago. Three weeks later, he died.

The culprit was not his head wound but an infection from staphylococcus aureus, a common bacteria that can be deadly if it enters the body at a vulnerable point -- like near the incision doctors made when they inserted a tube to help Brad Moore breathe.

His mother cried Thursday as she talked about the infection that claimed her son's life, during a news conference held to encourage hospitals to disclose how many of their patients become ill or die because of bacterial infections caught while in their care.

"I don't want to see another mother lose her child," she said.

Joining her was former Lt. Gov. Betsy McCaughey, a health policy researcher who recently formed the Committee to Reduce Infection Deaths. The committee is pushing the state's hospitals to improve their hygiene to save lives.

Two million Americans get infections in hospitals each year, and about 103,000 die, according to the federal Centers for Disease Control and Prevention.

Of particular concern is MRSA, strains of staphylococcus aureus that have proved to be resistant to nearly all antibiotic treatments.

There is no mystery as to how to combat hospital infections from regular staph or from MRSA, according to RID. Improving staff hand-washing, systematically disinfecting furniture and equipment, and requiring doctors and nurses to wear disposable aprons can cut rates substantially.

McCaughey pointed to hospitals that have experienced rapid improvements. The Latter Day Saints Hospital in Salt Lake City cut its infection rate in half by focusing on pre-surgical hygiene, while Bloomfield Hospital in England established policies that cut the infection rate in its orthopedic unit by two-thirds in just one year. Bloomfield urged hand-washing and equipment cleaning, banned nurses from wearing jewelry, began using disposable aprons, forbade visitors from sitting on beds, and tested patients for bacteria several days before surgery so they could use special soap to kill the germs before patients entered the hospital.

The best way to push New York's hospitals to take those steps, according to the committee, is to publish infection rates at each hospital. That would help consumers decide where to go for surgery and would shame the lowest-performing hospitals into cleaning up their act.

That report-card approach works, McCaughey said, pointing to the experience of coronary bypass surgery death rates, first released by the state in 1991. As they became public, hospitals scrambled to boost survival rates. "And New York became the state with the lowest mortality rates in the nation," she said.

Assemblyman Richard Gottfried agrees. "Public disclosure will encourage hospitals to do more to control infections," said the Manhattan Democrat, who chairs the Assembly Health Committee. Gottfried plans to revise a bill he had previously introduced so that it focuses more specifically on mandating infection rates.

Several other bills in the state Legislature would mandate hospital reporting, as Florida, Missouri, Pennsylvania and Illinois did recently.

The involvement of McCaughey, a vibrant and outspoken woman who ruffled feathers while in Albany during Gov. George Pataki's first term, gives those bills hope, said Blair Horner, legislative director of the New York Public Interest Research Group. "The fact that she is focused on this will probably raise these issues up for discussion, " Horner said.

Hospital trade associations say that while the group's mission is noble, it ignores the work that hospitals are already doing.

Many hospitals are participating in a six-year, state-funded project organized by the Iroquois Healthcare Association that is intended to cut MRSA rates.

"Hand-washing is critical," said Carole Van Antwerpen, Iroquois' infection control project director. Most hospitals have waterless antibacterial soaps available at dispensers at each room door, which weren't there just a couple of years ago.

The hospitals joining the Iroquois effort -- including Albany Memorial, Ellis, Samaritan, Saratoga, St. Clare's and St. Mary's -- began putting the program's recommendations in place on March 1.

"We're doing a tremendous amount already," said Kathleen Ciccone, vice president for quality and research for the Healthcare Association of New York State.

Ciccone said that while the association backs a hospital report card for infections, it is difficult to publish data that can be compared between hospitals, so that a hospital wouldn't be penalized for treating patients with conditions like AIDS that leave them vulnerable.

"It's not that people are hiding data," Ciccone said. "It's that it is simply not available in a form that would be useful today."

A state Department of Health spokesman called its infection surveillance system one of the strongest in the nation and said the department is reviewing legislative proposals that would make infection information public.

McCaughey is skeptical about the practices that hospitals claim are already in place, pointing out that more intensive measures in nations like Denmark and Holland have nearly eliminated MRSA infections while U.S. rates continue to climb.

McCaughey, who gained public attention in 1994 when she was writing for the Manhattan Institute in criticism of the Clinton administration's health care proposals, said she decided to found her committee after looking at childhood photos of Brad Moore at his mother's Orange County home.

"Enough with the research," McCaughey said she thought at the time. "I've got to do something about this."

McCaughey is angriest at hospital officials who told her that "it's hard to change the culture in the hospital" when she urged them to make cleanliness and hygiene priorities.

"Do you know what's really hard?" she asked. "Talking to a mother who just buried a 28-year-old son for no good reason."

Matt Pacenza can be reached at 454-5533 or by e-mail at mpacenza@timesunion.com.