Law aims to curb hospital infections.

Byline: Tim Christie The Register-Guard

People go to the hospital to get well, but too often, patients pick up nasty infections in a health care setting that can make them sick or even kill them.

About 2 million hospital-acquired infections occur each year in the United States, responsible for about 90,000 deaths and $4.5 billion in excess costs, according to the U.S. Centers for Disease Control and Prevention.

Now Oregon is poised to become the latest in a growing list of states that require hospitals to publicly report their infection rates for certain procedures. The idea is that disclosure, and the resulting public and peer pressure, will spur hospitals to work harder to reduce their infection rates.

Both chambers of the Legislature passed House Bill 2524 by wide margins in the just-completed session, and Gov. Ted Kulongoski is expected to sign the legislation by the Aug. 9 deadline, said his spokeswoman, Anna Richter Taylor.

The bill calls for the establishment of the Oregon Health Care Acquired Infection Reporting Program and an advisory committee that together will decide which infections hospitals will be required to report.

The health policy office will publish an annual report on hospital-acquired infections starting in January 2010. Starting in January 2011, the information will be updated quarterly.

Hospital-acquired infections are costly. The average cost of a hospital stay in Oregon for a patient with a hospital-acquired infection is $32,000 more than that for a patient who does not get such an infection, according to the Office for Oregon Health Policy and Research.

In 2005, hospital-acquired infections in Oregon resulted in $15 million in excess costs, the health policy office said.

Then there are the human costs. Patricia Dehning, a 79-year-old Portland woman, died in 2003 after she developed a drug-resistant staph infection, known as MRSA, while getting treated for a broken hip at a Portland hospital.

Consumers Union, the nonprofit publisher of Consumer Reports magazine, pushed for the Oregon legislation as part of a national drive to reduce hospital-acquired infections. With Oregon and New Jersey passing bills this year, 19 states now have such laws, said Lisa McGiffert, director of the group's Stop Hospital Infections campaign.

"We believe consumers have a right to know their hospitals' infection rates," she said. "It's a very basic measure of patient safety, and they can use it to make choices of where to go, if they have choices."

Even patients who don't have a choice of hospitals can use the information to put pressure on their hospital if needed, she said.

The Oregon Association of Hospitals and Health Systems supported the bill, but only after persuading lawmakers to change its language.

"We're not opposed to reporting of infections nor to public disclosure of those reports if it's done right," said Gwen Dayton, the group's executive vice president and general counsel.

The hospital lobby opposed language in the bill that listed which infections hospitals would be required to report. Instead, the hospital group wanted the advisory committee to decide on the infections that would require reporting along with details of how a mandatory reporting program would work, she said.

The 16-member committee will include representatives from large and small hospitals and nursing homes, as well as doctors and nurses. But a majority of the members must come from outside the health care industry.

The legislation lists three common infections that the committee must at least consider for required reporting: surgical site infections, central-line related bloodstream infections and urinary tract infections. It also says hospitals must report on "process measures" they're taking to reduce infections, such as hand-washing rates and providing patients with antibiotics before surgeries.

Dayton said the public disclosure of infection rates could be embarrassing for some hospitals. "But we think preventing infections is very important for patients," she said."

The legislation represents new thinking about how hospitals deal with infections and about what consumers want to know about health facilities.

"It is a culture change," said Judith Hibbard, a health policy professor at the University of Oregon who studies how consumers use information to make health care choices. "In the abstract, the idea of transparency and openness is viewed as a good thing, but it's still a difficult transition for hospitals to make."

House Health Care Committee Chairman Mitch Greenlick, D-Portland, one of the bill's sponsors, was research director for 30 years for Kaiser Permanente and chairman of preventive medicine for 10 years at Oregon Health & Science University. Health professionals and researchers used to believe that hospital-acquired infections were inevitable, he said.

"That's not the modern view anymore," he said. "The modern view is we need a zero-tolerance approach to hospital- acquired infections, and hospitals feel it's possible."

Hospitals are already taking steps to reduce infections. PeaceHealth, corporate parent of Sacred Heart Medical Center in Eugene, is conducting a "major internal campaign" to reduce infections, spokesman Brian Terrett said.

McKenzie-Willamette Medical Center did not return calls seeking comment on the bill.

Pump bottles of sterilizing gels are all over PeaceHealth hospitals, doctors' offices and administrative offices. Employees are reminded to wash or sanitize their hands any time they enter or leave an office, he said.

The next step is put posters in patients' rooms, encouraging patients to ask doctors and nurses whether they've washed their hands, Terrett said.

The hospital group also is tracking the number of employees who wash their hands through unannounced, random audits of different units and offices, he said.

PeaceHealth also is trying to remind would-be visitors to stay home if they're sick, rather than spread their germs in the hospital, he said.

2 million Number of hospital-acquired infections in the United States each year 90,000 Number of deaths caused by such infections annually $4.5 billion Cost of such infections nationwide; cost is $15 million in Oregon alone