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State's hospitals seeking to delay infection-data plan

Luis Fábregas
| Sunday, Dec. 28, 2003

The state's most influential hospital group wants to delay a controversial plan, slated to go into effect Thursday, forcing hospitals to disclose how many of their patients develop infections.

"Jan. 1 is problematic," said Roger Baumgarten, a spokesman for the Hospital and Healthsystem Association of Pennsylvania, which represents more than 200 hospitals. "We're looking for a delay. Our bottom line is we support the reporting but we want it done right. If hospitals are rushed to do something, is it going to be done right?"

The Pennsylvania Health Care Cost Containment Council, an independent state agency, said it has no intentions of postponing the plan it approved earlier this year. Health care consumer advocates consider it a bold step to improve the quality of care in the state's hospitals.

"Nothing has changed from our perspective," said Marc P. Volavka, executive director of the Harrisburg-based council. "We are going to move forward."

The federal Centers for Disease Control and Prevention estimates that about 2 million people contract hospital infections every year. Studies show deadly germs are often spread by nurses and doctors who do not wash their hands. The germs kill nearly 100,000 of the nation's hospital patients every year.

The council, which already collects data about hospital finances and medical procedures, has tried to collect hospital infection data since 1986. It renewed its efforts after the Pittsburgh Tribune-Review highlighted the issue in an October special report. But the council met resistance from the hospital industry.

In a November letter to Volavka, Carolyn Scanlan, the hospital association's president, raised several concerns about the proposal:

  • It is virtually impossible to conduct hospitalwide surveillance of infections as proposed by the council.

  • The council hasn't said how patients will be analyzed to determine where an infection was acquired.

  • The council did not get input from infection-control experts before making its proposal.

    The top concern appears to be whether a hospital is capable of measuring infections across an entire facility. The hospital group argues that the CDC recommends so-called targeted surveillance, which measures infections in selected parts of a hospital, such as an intensive care unit. Measuring infections hospitalwide is too costly and complex, the group says.

    Under the plan, hospitals would use the same software they already use to submit clinical information to the council. The information would include the number of infections in each of 14 categories, including four of the most common infections developed by hospitalized patients: pneumonia, surgical site, urinary tract and bloodstream infections.

    The council has not yet determined how it will publish the data for consumer use. It will not receive the first full year of data until March 2005 because, by law, hospitals have 90 days to submit it.

    Volavka, the council's executive director, said he is willing to work with the hospital association to address its concerns.

    "Ultimately, if there are constructive solutions that get us the data that we want, we'll work constructively with them," he said. "But if their goal is to roadblock the collection of this data, I can't see this council proactively cooperating in an effort to undermine what we believe is the right thing to do and what the law says we have to do."

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