Monday, July 6, 2009

Living Well

Report Spells Out How to Stop Hospital Infections

Posted April 17, 2008

Ten years ago, Edward Lawton's life took an unpredictable twist: While hospitalized and recovering from spinal surgery, he acquired several severe infections. Resistant to treatment, they ravaged his body, damaging his bones. Now, he is confined to a wheelchair.

Testifying on Wednesday before a U.S. House of Representatives committee hearing, Lawton, 58, spoke of what he has learned from his ordeal: that it's smart to be a vigilant patient. "I refuse to die because of someone's dirty hands or complacent attitudes," he said. Now, whenever he's in a hospital, he speaks up if he notices that basic sanitation standards aren't being met.

Healthcare-associated infections claim roughly 99,000 lives a year nationwide. The problem has not escaped lawmakers' attention, which is why they found themselves listening to Lawton's story.

Infections acquired in hospitals, clinics, and doctor's offices were the subject of the lengthy hearing held by the Committee on Oversight and Government Reform, the chief investigative committee in the House of Representatives. Congressmen and testifying experts discussed whether federal health officials are doing enough to protect patients from what many call a "preventable epidemic." Not nearly, according to a new report by the Government Accountability Office, released at the hearing, that was largely critical of the U.S. Department of Health and Human Services for not exercising leadership to reduce such infections. (The federal government isn't the only administration that needs to act. States are independently arriving at the same conclusion, as Pennsylvania indicated last week.)

"If you have to go to a hospital for treatment, you should be able to expect that you won't come out with something worse than what you came in with," said report leader Cynthia Bascetta, GAO's director for healthcare issues, during a recess after her testimony. "I hope HHS will incorporate our recommendations with a sense of urgency. This problem isn't going away."

Some of the lowest-hanging fruit for hospitals to prevent or control infections, the GAO said, is simply hand washing by healthcare workers. Other recommendations included the development of universal infection-control rules that U.S. hospitals would have to adhere to—or forfeit reimbursement payments.

In its annual voluntary survey of over 1,300 hospitals, the Leapfrog Group, a consortium of major employers advocating better healthcare, found last year that 87 percent of hospitals completing the survey don't take the recommended steps to prevent these avoidable infections. "It's disappointing," said Leapfrog's chief executive officer, Leah Binder.

"The inexcusable part to me is that these infections could be prevented with simple [measures]," said House Committee Chairman Henry Waxman in an interview. "We hoped this hearing would be an impetus for the department [of Health and Human Services] to do the job that they should be doing."

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