WA Bills Remove Critical Hospital Infection Reports from the Public View
Statement of Consumers Union
Bills Remove Critical Hospital Infection Reports from the Public View
SB 5415 and HB 1471
February 15, 2013
Consumers Union, the policy and advocacy division of Consumer Reports, is opposed to SB 5415 and HB 1471, unless they are amended. These bills propose to eliminate critical public reports on infections that patients get at hospitals from hip and knee replacement and heart surgeries. These surgeries have been in the Washington hospital infection reporting law since 2007. Both bills have moved out of committees this week without amendments, despite issues raised about removing these procedures.
Consumers Union was very involved with passage of Washington’s original 2007 hospital infection reporting law as part of our national Stop Hospital Infections campaign that led to passage of public reporting laws in 31 states. Several years ago we broadened the scope of our work to include prevention of other types of medical harm under the Safe Patient Project (www.SafePatientProject.org). We, along with our national network of local advocates, represent the consumer voice on hospital-acquired infection issues in many states and at the national level. In Washington state, we work closely with the Washington Advocates for Patient Safety and many other people who have shared their hospital infection experiences with us over the years.
We are opposed to these bills unless they are amended to retain the current law requiring reporting on hip and knee replacements and cardiac procedures. Coronary artery bypass graft (CABG) procedures are the most important. CABG is the most common surgical procedure done in America. The number of hip and knee replacements is increasing significantly every year and will continue over the next 20 years during which, according to the American Academy of Orthopedic Surgeons, hip replacements are expected to increase by almost 200% and knee replacements by an astounding 673%. Because they are so common and because of the nature of these procedures, consumers want to know about their associated infection rates. Surgeries on hips and knees are exactly the kind of procedures that consumers do research on – they are elective and people have time to plan ahead. Also, they are typically done on healthy patients in clean procedures that should never lead to infections – they are preventable. It makes no sense for Washington consumers to lose this valuable law that will provide critical information for their health care decisions.
Other issues with SB 5415/HB 1471
The bill’s caption and analysis indicate its purpose is to align the state reporting with the voluntary federal program. But the bill does not align reporting with the federal Inpatient Quality Reporting program that gives hospitals an annual 2% raise in Medicare reimbursement in exchange for reporting hospital-acquired infections and other quality measures. The bill omits three other infections required in the IQR program. To truly bring the law into alignment, these three should be added:
- Catheter associated urinary tract infections in ICUs, which hospitals began reporting in January 2012;
- Methicillin-resistant Staphylococcus Aureus (MRSA) Bacteremia Lab ID Event, which hospitals began reporting in January 2013; and
- c.difficile lab ID event, which also began in January 2013
Further, the bill merely gives authority to the Department of Health to determine if the state requirement should align with federal requirements. While this is an oversight of the bill – we believe hospitals are going to continue to report to the federal program, regardless of what the state law says because it translates to real money for their operations.
The hospitals say that public reporting takes too much of their resources and takes time away from prevention. First, CLABSIs in the ICU alone are a drain on health care resources, conservatively costing an estimated $26,000 per infection (using Medicare rates), according to the CDC. In 2011, 62 Washington hospitals reported 113 CLABSIs in their ICUs at a cost of $1.6 million – and this is only a small subset of all of the infections that occur in the state’s hospitals. The cost to human lives is immeasurable, including death, permanent disability, loss of ability to work, and years of pain.
Second, public reporting is a critical part of prevention – it is not busywork. Without it, no one would know if the prevention efforts of a hospital actually work. And, the first step in prevention is awareness of when and where infections are occurring – something most hospitals only had limited knowledge of prior to the attention brought to the issue through public reporting. Even CDC has said public reporting infections “is an important component of national HAI elimination efforts. Research shows that when healthcare facilities are aware of their infection issues and implement concrete strategies to prevent them, rates of certain hospital infections can be decreased by more than 70 percent.”
We urge the Legislature to keep consumers informed by amending SB 5415/HB 1471 so surgical infections from hip and knee replacements and CABG procedures will be reported to the public.
For more information:
Lisa McGiffert, Director, Safe Patient Project
512-477-4431 ext 115