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Updated: Wednesday, 23 Nov 2011, 2:53 PM EST
Published : Tuesday, 22 Nov 2011, 11:06 PM EST
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
government Hospital Compare website now contains information about a couple of process measures; how frequently the right antibiotic was given at the right time to prevent infection.
As we have seen with the ICU catheter-related infection campaign of the Keystone Initiative, focusing on behavior of health care workers is the direction infection prevention has taken.
Just getting health care workers to wash their hands between patients has been a big deal.
"Over the last few years we've made great strides in actually accomplishing changing that number, which often in many institutions is 40-50% to well over 95% here at Spectrum Health," said Dr. Dobbie.
But without knowing actual numbers of patients who get infections in each hospital it's difficult for consumers to know just how effective those process measures are, according to critics.
The Center for Disease Control has broadened the scope of its effort to examine infections by now referring to Health Care Acquired Infections (HCAI) , acknowledging that patients can get infections outside the hospital.
Anastasia Miller knows about both. When she was pregnant a few years ago and living in Battle Creek she became dehydrated and was receiving fluids through a central line while she was at home. She got an infection around that catheter and "found that I had two blood infections," she says. "I had an abcess on my shoulder. I had a staph infection at the site where the PICC line was."
So she went back into the hospital where she got yet another infection, C. Diff., an intenstinal malady that has become one of the well-known hospital infections.
"It was not enjoyable," she said. "A lot of cramping, a lot of pain."
She spent nearly six weeks in the hospital and was able to give birth to a healthy baby but the experience left her family in deep financial trouble. "I didn't have any kind of short term disability and we lost everything because of our medical bills," she says.
It has also left her with some advice learned the hard way. She said patients need an advocate to watch out for their medical care. Or they need to be the advocates for their own safety. If patients see things that worry them they have to speak up, she said.
"Ask questions...when things are happening or you're starting to feel sick, to not let it fall on deaf ears."
Ken Kolker joined 24 Hour News 8 in January 2009 after 30 years as a newspaper reporter.
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