Within the past decade, healthcare-associated infections have become a critical issue for American hospitals. Consumer groups and the media have elevated these infections to something of a cause celebrea fact that has created state and federal legislative pressure. Currently, 27 states require some type of public reporting of these infections, and pending federal legislation would also require public disclosure of infection rates.
Congress recently mandated major changes to Medicare reimbursement effective this October. Starting then, the CMS will stop reimbursements for eight conditions considered preventable that develop after a patient is admitted to a hospital. In 2009, the CMS will add more to the list. Half of the conditions for which the CMS will no longer pay are infections.
Increased calls for transparency and accountability, along with threats of denied reimbursement, certainly raise the stakes for hospital leadership. But in addition, consider that, according to the Centers for Disease Control and Prevention, more than 70% of the bacteria that cause hospital-associated infections are resistant to at least one of the drugs most commonly used to treat them. With a limited arsenal of new drugs on the horizon, preventing infection must be the priority. It also is making more sense from a business perspective. Generally, only larger hospitals employ physician epidemiologists, but every hospital has infection prevention and control professionals. The dollars spent on them are much less than the cost of infections.
Preventing nosocomial infections only happens when top leaders target zero infections as the vision and heed the advice of infection prevention and control professionals. These specialists work to identify and isolate sources of infections to limit their spread. That includes collecting, analyzing and communicating data to advance performance improvement and safe practices. In the face of public pressure to reduce nosocomial infections, its time for leaders to understand the often overlooked talents that these professionals bring to saving lives and improving the bottom line.
Methicillin-resistant Staphylococcus aureus is now emblazoned on the popular consciousness as a result of reports that it kills more Americans than AIDS. In 2007, the Association for Professionals in Infection Control and Epidemiology, or APIC, conducted the first nationwide prevalence study, which showed that the rate of MRSA is eight times higher than previously estimated.
Forward-thinking hospitals are replacing finger-pointing with fresh insights and innovations led by their infection-control professionals. A bundle of elimination strategies, comprising evidence-based best practices, is highly effective at combating the spread of MRSAbut only when employed consistently. When everyone does it right the first time, 100% of the time, dramatic and measurable progress results.
In an informal APIC polling, we asked members to identify whats changed over the year since the prevalence study. More than three-quarters (76%) of respondents said additional MRSA interventions were adopted. Yet more than half (54%) said that their institutions were not doing as much as is necessary to prevent the spread of MRSA. So while this progress marks an excellent start, there is more to be done to combat these infections.
Adhering to the fundamental principles of MRSA prevention will reduce other types of infection as well. Success means that leaders establish an organizational culture that strives to eliminate preventable infections and allocate resources to efforts that target institutionwide prevention, education, measurement and process improvement.
Other potent benefits accrue to the hospital committed to thinking differently about infection prevention and control, especially if leaders are willing to declare it as an organizational priority and support it with adequate resources. In such an environment, infection prevention ceases to be a stand-alone department; rather, it adds value to every aspect of patient care. Lessons learned from infection prevention can improve other areas of patient safety, foster transparency and raise the organizations standing in the community.