Hospitals, infections, changes and you

GRAND RAPIDS, Mich. (WOOD) - One in every 20 patients gets some sort of infection while they are in the hospital and around 99,000 die every year in the US, according to the Center for Disease Control (CDC).  But in most communities patients can't find out exactly how many patients at their local hospital get an infection or how many die from it.

Target 8 Investigators found that since they probed hospital-acquired infections 11 years ago, information about individual hospital infection rates remains a secret in most places, but in some states legislation has required some reporting of hospital acquired infections.   

Michigan is not one of them.  

A disclosure bill introduced in the Michigan legislature in 2009 died in committee and how much public disclosure it would have provided remains unclear. The legislator who introduced it, Rep. Lesia Liss , did not return out phone calls or emails.

A little information is beginning to creep out of the health care industry about hospital infection numbers. That's because in the last decade there has been a major change in attitude in health care about infection control. There used to be a kind of fatalism about infections among health care workers, an attitude that there wasn't much anybody could do about them.

"I think there's much more of a focus on health care-acquired infections," said Grand Valley Health Plan CEO Ron Palmer.

Most Michigan hospitals joined the Keystone inititative aimed at a specific category of infections. It was an effort to reduce central line-associated blood stream infections in intensive care units.

Using a check list to maintain safe procedures, they reduced infections by 66%.  That's a major success story and hospitals are willing to share that information on the government's Hospital Compare website. 

State and local governments are also collecting more information about infections from hospitals but government agencies have to sign confidentiality agreements to get it and promise not to reveal individual hospital statistics publicly.

The kind of infections people get in hospitals has changed in the last decade, too, with the increasing frequency of infections that have become resistant to many drugs that are used to fight them.  One of them is MRSA , a staph bacteria that has developed a resistance to many of the common bacteria killers. It is found in the general environment and in hospitals now.

A few weeks after she went home from a week in the hospital, Kent County resident Deb Gallup "developed these huge, like, boils on my buttocks."   It was MRSA.  "It's going to always be with me," she said. "It's very frustrating. Some days I feel like a leper."

Gallup said it has affected her job and her personal life, as episodes come and go over time. She is particularly angry that MRSA has forced her to stay away from her sister - who has a compromised immune system because of a bone marrow transplant - and has to avoid infections.  

"She's very special to me," Gallup said, "and one of these days she's going to need me and I can't be there for her."

Gallup believes she got MRSA while she was in the hospital over Christmas 2008.  But a letter she got from Metro Health said that her particular strain of MRSA hadn't been found in the hospital at that time and "there's no way to determine" if that's where she got it.

The difficulty of pinning down the source of infections is one of the reasons hospitals hate the idea of having consumers compare them on their infection rates.  It's hard to know whether a patient brought an infection with them or got it after they left or acquired it while in the hospital.

And if they did, was it caused by something the hospital did or didn't do?

Another confounding factor, hospitals believe, are differences in the kind and intensity of illnesses people bring to the hospital.

"Just because you have numbers doesn't mean that they can be meaningfully compared because of differences in risk factors for patients that come to us,"  said Spectrum Health infection specialist Dr. David Dobbie.

Hospitals say it would require extensive public education for consumers to understand the numbers if they were disclosed.  For example, people would need to know how much infection is acceptable, how much is not. Grand Valley Health Plan CEO Palmer agrees that there is a valid fear of misunderstanding around the idea of public disclosure but he remains in favor of it.

"I think that possibly we've kept people in a kind of Pollyana-state around the fact that there are risks associated with all types of medical care," he said.

Instead of revealing raw numbers of infections and deaths, hospitals are more willing to reveal information about things they do to prevent infection.  

"What we speak to publicly is the processes and how well we're being successful in those processes," said Saint Mary's Hospital infection control specialist Kim Greenwald.

For example, the