An estranged lieutenant governor, Elizabeth McCaughey, who openly criticized the Pataki administration and eventually defected from the Republican Party to run against her former boss, returned to Albany yesterday to throw some bombs at a new target: hospitals.

Ms. McCaughey, an outspoken advocate of improving hygiene at health-care facilities as a way to reduce deadly infections, established the Committee to Reduce Infection Deaths, or RID, to increase awareness of the issue. She cited numerous studies in arguing that washing hands and instruments dramatically reduces infection deaths.

She called on doctors and hospital staff to adopt habits of cleanliness as a way to prevent the spread of infection and urged hospitals to issue report cards on infection rates that would be immediately available to patients.

Ms. McCaughey was joined by a tearful woman from Orange County whose son died three years ago from an infection he picked up at a New York hospital.

“What I am calling for is a revolution in how medicine is practiced, to make hygiene and cleanliness central to the practice of medical care again, as it was 50 years ago, before the liberal use of antibiotics replaced attention to cleanliness,” Ms. McCaughey said at a press conference near the state Capitol.

Ms. McCaughey named names in her attack on the medical establishment, zeroing in on the Healthcare Association of New York State, a trade association of roughly 550 not-for-profit health-care facilities.

In a March 14 letter, she also took a swipe at the group’s president, Daniel Sisto, for declining an invitation to join her group.

Holding up the letter, Ms. McCaughey said Mr. Sisto has rejected the idea of infection report cards because he thinks they are unfair to hospitals where infection rates are influenced by client base and locale. She said the report cards she has in mind would be adjusted to account for those differences.

“Mr. Sisto says hospitals in New York State are already fully engaged in the effort to improve quality and prevent infection,” Ms. McCaughey said. “Are hospitals in New York doing enough to protect patients from infection? Dan Sisto says yes. But I say no. And I know that that’s the truth.”

A spokesman for Mr. Sisto said his organization is already addressing hospital-acquired infections.

“We take the issue seriously, which is why we’re providing leadership to address it,” Mr. Sisto said. “We are discussing it with our members, the media, and elected officials.”

The spokesman, Matthew Cox, added that, in his view, Ms. McCaughey is not a strong-enough authority on which to base a statewide policy change.

“I’m not new to this issue,” Ms. Mc-Caughey shot back over a cell phone as she traveled home to New York City. “I’ve been writing about these issues for years. If he says he wants to work with organizations that have been doing this for years, those organizations have been doing this for years with no results.”

According to Ms. McCaughey, hygiene has become increasingly important as bacteria such as staphylococcus aureus, or staph, mutate to resist antibiotics. She cited statistics indicating that 2% of hospital infections were resistant to antibiotics in 1974 and today 57% are.