Great news! Earlier this week in Washington State, Governor Jay Inslee stood with consumers by signing a bill into law that keeps current reporting on infections associated with hip and knee replacements and cardiac surgeries. The bill also requires hospitals to report on additional types of infections.
The bill passed the House and Senate unanimously, even though the Washington Hospital Association opposed an amendment to it that retained reporting requirements for the three procedures. The amendment was pushed by Consumers Union’s Safe Patient Project and the Washington Advocates for Patient Safety over the objections of the hospitals and the Department of Health, the two groups that supported the original bill that removed the three surgeries from public reporting. Local activists testified at committee hearings, over 3300 Washingtonians sent emails to legislators in support of the amendment and 250 people called the Governor’s office to ask him to keep the Consumers Union amendment.
The Hospital Association asked Governor Inslee to veto a section that would have eliminated our amendment – they stated reporting on these surgeries “would be a burden to hospitals”, “is too time-consuming for the benefit gained” and that the procedures do not have significant infection rates. Safe Patient Project Director Lisa McGiffert wrote a letter to Governor Inslee asking him not to veto the reporting section of the bill.
Reporting on infections for the three procedures was mandated in 2007 with the Hospital Infection Reporting Law. But consumers have only seen one year of information so far, making it impossible to establish trends. That report shows that Washington hospitals had varying infection rates for hip and knee replacements, ranging from zero to nearly one in 20 patients in larger hospitals, and as high as 14% in smaller hospitals. Consumers Union was told by the Department of Health that 250 hip and knee replacement patients were infected in Washington hospitals during this first reporting period. (Unfortunately, the public report does not give the total number of infections, just the rates.) While infection rates overall may seem “low”, the high volume of these mostly “clean” surgeries translates to a lot of people being harmed by infections that should have been prevented.
The WA Secretary of Health claimed that reporting on these high volume surgeries was “outdated.” Instead, he indicated it was more important for the state law to require hospitals to report on several lower volume surgeries that they are already reporting to the federal government (abdominal hysterectomies and colon surgery). Frankly, we believe most consumers want hospitals to account for all infections that occur in their facilities, not just the ones deemed “important” to health care providers.
It’s important to gather data from several years to accurately monitor these surgical infection rates, especially because the number of hip and knee replacements is increasing significantly every year. Surgeries on hips and knees are exactly the kind of procedures that consumers do research on – they are elective and people often have time to plan ahead. Reports on these specific surgical infections will end in Washington in 2017; by then we hope to see the federal government include reporting of these infections in its public reporting program.
Washingtonians should send a big thank you to Governor Inslee for siding with patients and acknowledging: “…these infections can be so catastrophic that I think it warranted this effort to reduce infections…what we have found is there can be very profound improvement of infection rates once we focus hospitals on trying to make those improvements. So I thought it was the right move.”