Healthcare-associated infections, the panel

The panel at the Association of Health Care Journalists' annual meeting exploring mandatory reporting of HAIs was very successful (she, the moderator, says modestly). Speakers were:

• Chesley Richards, MD, deputy director of the CDC's Division of Healthcare Quality Promotion
• Betsy McCaughey, PhD, founder and chair of RID, the Committee to Reduce Infection Deaths
• Carmela Coyle, senior vice president for policy at AHA, the American Hospital Association
  
• and Carole Moss, whose son Nile died of MRSA and who founded Nile's Project in his memory.

Notable points from the panelists:

• Richards: The CDC acknowledges that its collaborators feel the agency took too long to take this issue seriously, but "we're there now."
• Coyle: Hospitals think a uniform data standard should be set for reporting, so that rankings will be apples-to-apples comparable across the industry.
• Moss: Victims and families are concerned that healthcare infections have become an industry, and that there is no financial incentive for hospitals to reduce infection rates.
• McCaughey: HAIs are twice as prevalent as the CDC calculates: Not one out of 20 hospital admissions, but one out of 10. Arguments that infection control is too costly ignore the groundbreaking work done by Carlene Muto et al. at University of Pittsburgh Medical Center: Their enhanced surveillance and control of ICU patients achieved a 20-to-1 payback.

Pithy final comment from McCaughey: "We have the knowledge to reduce hospital-acquired infections. What we lack is the will."

Hospital MRSA - should healthcare institutions be forced to report it?

I'll be moderating a panel exploring that contentious issue at the Association of Health Care Journalists' annual meeting in March. On the panel:

• Carmela Coyle, senior vice president for policy, American Hospital Association
• Betsy McCaughey, Ph.D., CEO and chair, Committee to Reduce Infection Deaths
• Carole Moss, executive director, Nile's Project
• Chesley Richards, M.D., M.P.H., deputy director, Division of Health Care Quality Promotion, U.S. Centers for Disease Control and Prevention

A number of states have passed laws in the past few years that require public disclosure of hospital-acquired infections, and a half-dozen have added provisions that specify reporting HA-MRSA. It seems like a no-brainer: Shame is a great motivator.

But some citizen-advocates are concerned that clever or well-funded institutions will be able to game the system. And some researchers who have evaluated infection-reporting regimes warn that surveillance often misses patients and reporting regimes are not standardized from state to state.