Last April Dr. Peter Pronovost of Johns Hopkins University testified before the House Committee on Oversight and Government Reform about his “checklist” to prevent central-line-associated bloodstream infections. When Michigan hospitals joined his efforts by using the checklist in their intensive care units, the overall rate of ICU infections was reduced by 66% but the typical (median) hospital in the state virtually eliminated them. The program, which also saved more than 1,729 Michigan lives and over $246 million, also requires education and support to staff and measuring the results.
So, the Committee set out to find whether other state hospital associations were doing anything to encourage their members to systematically implement these simple, life-saving practices (handwashing, full draping of the patient, cleaning the skin with proven cleansers, avoiding catheters in the groin when possible, and removing the catheters as soon as possible) and to monitor the results.
The Committee found that only eight state hospital associations even gather comprehensive information about the rate of central-line-associated bloodstream infections (among the most common types of hospital-acquired infections) and another 12 said they had started doing so. Only 13 states were using or planned to use the Johns Hopkins model.
While most US patients cannot yet count on their hospital to aggressively prevent these hospital-acquired infections, eventually we will be able to identify those who are. Twenty-four states now require public reporting of these infections — almost all include central-line bloodstream infections.