State issues improved guide to hospital infections

This story has been updated with reaction and new information.

California health officials Friday unveiled new hospital-acquired infection rates for hundreds of private and public hospitals and vowed to become a national leader in making that data public for consumers to review.

The barrage of reports appears to reflect a major change from January 2011, when the state stumbled badly in its first-ever release of statistics on patients who suffered infections during hospital stays.

Concerns about such infections have soared nationally in recent years. They kill an estimated 13,500 California hospital patients each year, according to a 2009 state report. That's more than four times the number of people killed in state traffic accidents. Nationally, an estimated 240,000 patients annually develop infections.

 This year, the department’s leaders say that their reports are thorough enough that consumers can now compare hospitals on certain infections, especially on one of the deadliest types, so-called central line infections. Such infections are estimated to kill thousands of people nationally and cost up to $2.3 billion in extra care.

The state Legislature mandated the public reporting in 2008, but California already was lagging behind many other states in such efforts.

Last year, the state Department of Public Health warned consumers not to use its first report to compare hospitals, calling those reports flawed by missing data and statistical shortcomings.  At the time, California was the 28th state to make hospital infections data public.

Now, state officials vow they’re turning things around after a rocky start last year.   

“This really confirms the (Brown) administration’s recognition of the importance of this issue,” said Kathleen Billingsley, the department’s chief deputy director. She promised that updated reports will be issued in July with “even more data than we had before, and even better data.”

The problem remains a major challenge, she and others said. Currently, infection control problems account for four of the top five deficiencies discovered in the state's surveys of patient safety at hospitals, they said.

The new reports won praise from representatives of both hospital and consumer groups.

Patient advocate Lisa McGiffert, who heads the patient safety arm of Consumers Union, said the new reports mark a “milestone” in state disclosure of infection numbers.

State Sen. Elaine Alquist, D-Santa Clara, who sponsored the 2008 law, said in an email that she is pleased that the reporting by hospitals has increased significantly, along with data quality.

“…Consumers can use this valuable information when researching hospitals for their healthcare needs,” Alquist said.

The new reports are significantly better than last year’s and will be studied carefully by hospitals, said Jan Emerson-Shea, spokeswoman for the California Hospital Association.

But one patient advocate is not entirely satisfied. Carole Moss, who spearheaded passage of the 2008 law after the death of her 15-year-old son from an infection, said that she is disappointed that some hospitals still did not report data, and she will await to see if more data in included in the July reports.

But state officials said California is now pulling ahead of other states in some of its reporting.

One report released Friday, for instance, looks at how successfully workers in hospital intensive-care units are following standards as they insert special lines near the hearts of patients to be used for feeding and medication. State officials call it the first of its kind.

Sloppy practices such as unwashed hands are a major cause of infections in patients’ bloodstreams, experts say.

Another report that the state calls a “first” provides data from hospitals on infections that patients acquire during certain surgical procedures. Such infections caused an estimated 8,200 deaths in the United States in 2002, the latest data available, the report states.

The reports contain hospital data on three other well-known types of infections frequently transmitted in hospitals:  Clostridium difficileMethicillin-resistant Staphylococcus aureus, or MRSA, and Vancomycin-resistant Enterococcus bloodstream infection.

Most of the new reports are thick, filled with technical language and data, which drew criticism from consumers last year. State officials say they have worked to make some reports more consumer friendly, including the one on line infections. Future reports will include more easy-to-read features, they said.

Resources: Earlier stories by the center on hospital infections are here.

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