Hospitals Collaborate To Change Methods To Prevent Infections

Even as federal officials announced that Medicare will no longer pay the cost of treating preventable, hospital-based infections and injuries, a group of New York hospitals has been quietly exchanging tips for reducing such incidents.

A consortium of 47 hospitals, including 28 in New York City, is set to expand a collaborative effort launched three years ago to reduce hospital-based infections. In addition to the change in federal reimbursement policy, the expansion comes as state health officials have started collecting data on infections from hospitals that it plans to publicize next year for the first time in a report card format.

Officials from the state's Health Department said the agency is also preparing to underwrite collaborative efforts to reduce infections, a $1 million push over the next year. The department plans to issue a request for applications from nonprofit groups with such proposals.

"We want to put our money where out mouth is," the health department's director of the Hospital Acquired Infection Reporting Program, Rachel Stricof, said during a recent conference on improving health care quality.

Hospital-acquired infections represent a serious problem nationwide, with patients developing an estimated 1.7 million infections each year. In New York, hospitals spend at least $2 billion each year treating preventable infections, according to a New York-based group, the Committee to Reduce Infection Deaths. Regional statistics on infection rates do not exist, but nationally, infections occur in one out of every 20 patients. "It is certainly not lower in New York," the founder of CRID, Betsy McCaughey, said.

Ms. McCaughey said poor hygiene is largely responsible for infections in hospitals. On average, hospitals spend up to $70,000 for each patient who acquires an infection during a hospital stay.

In 2004, the collaborative launched by New York hospitals was aimed at reducing central line-associated bloodstream infections. "We just said, ‘Somebody has got to make a change,'" the president of the United Hospital Fund, James Tallon, said. Since then, the hospitals' collective infection rates have dropped, according to data obtained from UHF and the Greater New York Hospital Association, which helped spearhead the collaborative. In April 2007, hospitals reported monthly infection rates of 1.76 for every 1,000 central line days, down from 5.01 in June 2005, the organizations reported. Prompted by such success, the consortium has since focused on rapid response systems to quickly detect cardiac emergencies, and in July, the group announced it would take on the increasingly common infection C. difficile, an oral-fecal contamination that can be fatal.

According to hospital officials, the consortium's online forum has allowed clinicians to break down previous barriers to sharing best practices.

"We encouraged people to beg, borrow, and steal," the chief patient safety officer at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, Joseph Cooke, said.

The chief of infection control at Beth Israel Medical Center, Brian Koll, said his hospital's medical and surgical unit created a kit and monitoring plan for dealing with patients with central lines. Within 90 days of implementing the measures, the unit's infection rate dropped to zero from 11 infections for every 1,000 central line days, prompting hospital leadership to do a "happy dance," Dr. Koll said.