"Hospitals are dirty."
That is the conclusion of Dr. Alfonso Torress-Cook, the chief of a hospital's infection control program in Long Beach, California.
Torress-Cook has a lot of support for that opinion. The Centers for Disease Control and Prevention estimates that about 90,000 patients die each year in hospitals across the country from post-operative infections and infections that result from medication errors, airborne germs, contaminated tubes delivering medications, staff failure in hygiene compliance and other factors.
A panel of scientists deemed hospital safety a top priority for the country over a decade ago, and material changes for the better are beginning to take effect, although not uniformly in all institutions and at a pace that frustrates some hospital administrators and medical researchers.
Those changes are driven by peer pressure and ego -- large and established hospitals want to be perceived as having a safe environment and untarnished safety record -- and by money.
The latter factor is turning out to be an especially compelling agent for change, especially in the wake of new Medicare rules and laws enacted in many states that now impose infection-rate reporting requirements on hospitals, which are made public. The numbers can enhance, maintain or hurt a facility's reputation.
Given that result, some hospitals are making a cost-benefit determination. A few are not reporting at all, despite financial penalties that attach for failure to comply. In California, for example, 19 hospitals out of 400 did not report infections as required. The state is giving them a one-year free ride on that, while it improves its data-collection methods. A lack of response next year, though, will result in those hospitals having Medicare payments reduced.
That result can issue even for a duly reporting hospital. Beginning next year, for example, Medicare will cut payments to facilities having high infection rates in their intensive care units. Medicare is already looking at hospitals' rates of catheter-related blood stream infections and will require hospitals to report surgical-site infections from next year.
There is strong agreement among many hospital administrators and researchers that the carrot and stick -- report and penalty -- approach will ultimately yield widely positive results and greatly reduce the hospital infection rate across the country.
Related Resource: NPR, "Hospitals Face New Pressures to Cut Infection Rates" May 28, 2011
