Many Hospitals Fail to Reduce Infection Rates Despite Checklists

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WASHINGTON—Far too many hospitals fail to lower the rate of deadly central-line bloodstream infections despite the availability of a simple life-saving checklist proven to prevent hospital-acquired infections, according to a new investigative article in the March issue of Consumer Reports.

The report coincides with the addition of infection rates to Consumer Reports’ in-depth hospital ratings available online at http://www.consumerreportshealth.org/.   

“For far too long, consumers have been in the dark, with no easy way to find out how well their hospitals perform when it comes to these often deadly infections,” said John Santa, MD, MPH, director of the Consumer Reports Health Ratings Center.

Consumer Reports collected and compared data for ICUs in 926 hospitals, finding tremendous variations within the same cities and even within the same healthcare systems. Central-line bloodstream infections cause at least 30 percent of the estimated 99,000 annual hospital-infection-related deaths in the United States and add an average of $42,000 to the hospital bills of each ICU patient who gets a central-line infection.

Poorly performing hospitals include several major teaching institutions. Some examples include New York University Langone Medical Center in New York City, the University of Virginia Medical Center in Charlottesville, the Cleveland Clinic in Ohio and Weston, Fla., Strong Memorial in Rochester, N.Y., Hackensack University Medical Center in New Jersey, Robert Wood Johnson University Hospital in New Brunswick, N.J., and the Santa Monica UCLA Medical Center in California. 

Meanwhile, determined reformers across the country have shown that hospitals can cut their infection rate to zero. Those hospitals range from modest rural hospitals to urban giants such as the University of Pittsburgh Medical Center Presbyterian. Other hospitals that have reported zero infections include St. Joseph Medical Center in Tacoma, Harris Methodist in Fort Worth, Santa Clara Valley Medical Center in San Jose, and seven Kaiser hospitals in California. The full list of 105 U.S. hospitals that have tallied zero central-line infections in their most recent reports can be found at http://www.consumerreportshealth.org/.

“All hospitals should be aiming for zero infections,” said Santa. “The procedures needed to eliminate ICU infections are simple, low-tech, and inexpensive, requiring a change of mindset and culture. All ICUs should be able to dramatically reduce if not eliminate these infections,” continued Santa.

Consumer Reports lays out the five simple steps contained in a low-tech, low-cost checklist developed by Peter Pronovost, MD, PhD, critical care specialist and patient-safety researcher at the Johns Hopkins School of Medicine. He tested the checklist in Michigan, where a dramatic 66 percent reduction in central-line bloodstream infections was recorded in hospitals that adopted the checklist. It is estimated that the program saved more than 1,500 lives and $200 million in the first 18 months alone.  

However, despite progress, and Health and Human Services Secretary Kathleen Sebelius’s recent call on hospitals to use the checklist to reduce central-line infections in ICUs by 75 percent over the next three years, an abundance of hospitals have not adopted the lifesaving checklist.  

In a section of its magazine report headlined “Freeing the Data,” Consumer Reports describes a culture of secrecy at the federal government. Under the assurance of strict confidentiality, the Centers for Disease Control and Prevention (CDC) has been collecting and analyzing infection data from hospitals since the early 1970s. Another federal agency, the Agency for Healthcare Research and Quality, collects data from hospitals in 42 states and uses the information to track trends in quality, costs, and utilization, but it reports its findings only in the aggregate, without naming any hospitals.

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