Statement for the Record
by The Hospital & Health System Association of Pennsylvania

Oversight and Investigations Subcommittee, Energy and Commerce Committee
March 29, 2006
Public Reporting of Hospital-Acquired Infections Rates:
Empowering Patients, Saving Lives

The Hospital & Healthsystem Association of Pennsylvania (HAP) represents nearly 250 Pennsylvania acute and specialty care, primary care, sub-acute care, long-term care, home health, and hospice providers, as well as the patients and communities they serve.

Pennsylvania hospitals recognize that preventing healthcare-acquired infections is a major public health imperative. Patients who acquire infections in a health care setting require more services and suffer additional consequences. Patients who require a central line or a ventilator in their treatment are far sicker and will always be more costly to treat, even if they do not contract an infection. Solving the problem of infections in health care requires the best efforts of doctors, nurses, regulators, insurers, patients, and their families—all working toward a common goal to reduce and prevent infections.

Hospitals in Pennsylvania have a long history of public reporting of quality and financial data and believe such reporting is important in demonstrating accountability for the quality of health care provided to patients in hospitals and other health care settings. We support the collection and public reporting of healthcare-acquired infection information that is useful for patients and purchasers of health care and is actionable by doctors and nurses in improving the quality and safety of care.

Infection is an inherent challenge in all health care settings and solutions must be based on good science and sound data. The Centers for Disease Control and Prevention (CDC) has developed the National Healthcare Safety Network, which uses clinical standards and methodologies. Pennsylvania hospitals are participating in the CDC network and believe that expanding the network will enable the use of consistent requirements and scientifically sound methodologies across the country. HAP believes the Centers for Disease Control and Prevention, working with other national organizations, such as the National Quality Forum, the Joint Commission on Accreditation of Healthcare Organizations, the American Hospital Association, and others can take a leadership role in developing consistent reporting approaches across all states.

The current methodology being used in Pennsylvania by the Pennsylvania Health Care Cost Containment Council to collect and report infection data should not be replicated across the country as it is not able to distinguish the actual impact of infections on hospital days, mortality and morbidity, or payments, and will not provide patients with useful information relevant to their diagnoses nor be helpful to doctors and nurses working to eliminate infections.

Collecting data for the sake of collecting data is not what is needed; rather state and federal agencies should be collecting data to turn into information that can be used by doctors and nurses to correct problems. Sharing this information and clinical methods to reduce and prevent infections is essential. That is why the CDC’s National Healthcare Safety Network should be expanded and why Pennsylvania hospitals will be working to do so.

PA Initiatives to Address Hospital-Acquired Infections

Pennsylvania hospitals want to achieve as much as possible in reducing healthcare-acquired infections through programs to identify, control exposure, and minimize risk to patients; and hospitals are involved in local, regional, state, and national initiatives to make care safer.

These initiatives are achieving success and include:

• The Institute for Healthcare Improvement’s 100,000 Lives Campaign in which more than 120 Pennsylvania hospitals are participating in the programs to prevent and reduce central line associated bloodstream infections and ventilator associated pneumonias. In Pennsylvania, HAP, regional hospital councils, the state’s Patient Safety Authority, VHA, and groups representing physicians and nurses are collaborating to bring best practices to hospitals across the state.

• The Pittsburgh Regional Health Initiative’s efforts in southwestern Pennsylvania, whose successful efforts over a four year period to reduce central line associated bloodstream infections were reported in the CDC’s October 14, 2005 Morbidity and Mortality Weekly Report.

• The Partnership for Patient Safety in southeastern Pennsylvania, a collaboration of the Delaware Valley Healthcare Council of HAP and Independence Blue Cross. This is a three-year initiative designed to enhance patient care at southeastern Pennsylvania hospitals and is initially focused on identifying and implementing best practice and evidence-based processes that will help reduce hospital-acquired infections.

• The national Surgical Care Improvement Program, which is a national quality partnership of organizations interested in improving surgical care by significantly reducing surgical complications, including healthcare-acquired infections.

Conclusion

The issue of preventing and reducing healthcare-acquired infections is important. Hospitals cannot tackle this issue alone and there is a role for everyone in making hospitals safer—including physicians, nurses, other health care professionals, federal and state government, and patients. There is much good work underway in Pennsylvania. Sound and scientifically accurate data will help hospitals to evaluate successes and share best practices, and identify the areas where there is still much to do.

National leadership, through the CDC and other organizations will ensure that there is consistency and clinical validity to the data on healthcare-acquired infections that is collected and publicly reported across the country. Pennsylvania hospitals believe that good data, consistently reported by hospitals across the country, will help patients and their families make important health care decisions and will support hospitals, physicians, and nurses in their efforts to prevent and reduce infections.