New York Hospitals Expand Efforts To Reduce Infections

By E.B. SOLOMONT, Staff Reporter of the Sun
December 17, 2007

A coalition of New York hospitals that has been working to reduce hospital-acquired infections is expanding its efforts, just as the state Department of Health prepares to publicly report infection data for the first time next year.

The 60-hospital group plans to focus on the bacterial infection, Clostridium difficile, as well as the safety of mothers and babies just before birth and immediately after.

In broadening the coalition's focus, its organizers said they hope to change the culture of hospitals and to improve the quality of health care. The new effort also calls for educating front-line hospital staff — everyone from physicians to housekeepers — on infection control.

"As we focus on small initiatives, they'll be able to morph these initiatives into broader ways to tackle things that happen that shouldn't," the vice president of quality and patient safety at the Greater New York Hospital Association, Terri Straub, said. The effort will be underwritten by a two-year $500,000 grant from the United Hospital Fund to the GNYHA Foundation.

Hospital-acquired infections represent a serious problem around the country. Nationwide, patients develop an estimated 1.7 million infections each year.

Regional infection data is not available for New York, although hospitals here spend an estimated $2 billion each year treating preventable infections, according to a New York-based group, the Committee to Reduce Infection Deaths. On average, hospitals spend between $25,000 to $70,000 treating each infection. Recognizing the cost and the health toll of such infections, the coalition of New York hospitals began in 2004 to focus on reducing bloodstream infections associated with a type of intravenous hookup called a central line. Since then, the collective infection rate among the participating hospitals has dropped, according to data obtained from the United Hospital Fund and GNYHA, which spearheaded the collaborative. In April 2007, hospitals reported monthly infection rates of 1.76 for every 1,000 central line days, down from 5.01 in June 2005, the organizations reported.

As part of the new effort, the UHF and GNYHA will also train physicians as Quality Fellows, who would become advocates for quality improvement at their own institutions. "We wanted to try to develop a cadre of physicians in these hospitals who were basically going to quality boot camp to learn the principles, skills, tools, and strategies that broadly apply to quality improvement," the project director of the United Hospital Fund's Quality Strategies Initiative, Rachel Block, said.

Organizers said other important components of a sought-after culture change include standardizing communication among staff, and educating front-line employees regarding infection control.

For example, individuals who transport patients play a pivotal role, Ms. Straub said. "Transporters had no idea that their failure to clean a stretcher properly could impact a patient's outcome… So when they hear what a great role they have they might start to think differently," she said.

So far, the collaborative does not have plans to directly address the spread of methicillin-resistant staphylococcus aureus, a bacteria that made headlines as a "super-bug" this fall after a Brooklyn boy died from the bacterial infection. However, organizers said they hoped the initiative would have a "spillover effect" that would reduce MRSA and other infections.