HHS Awards $17 Million in a New National Initiative to Fight Health Care-Associated Infections

/PRNewswire/ -- HHS Secretary Kathleen Sebelius today announced the award of $17 million to fund projects to fight costly and dangerous health care-associated infections, or HAIs.

"When patients go to the hospital, they expect to get better, not worse," Secretary Sebelius said. "Eliminating infections is critical to making care safer for patients and to improving the overall quality and safety of the health care system. We know that it can be done, and this new initiative will help us reach our goal."

HAIs are one of the most common complications of hospital care. Nearly 2 million patients develop HAIs, which contribute to 99,000 deaths each year and $28 billion to $33 billion in health care costs. HAIs are caused by different types of bacteria that infect patients being treated in a hospital or health care setting for other conditions. The most common HAI-causing bacteria is methicillin-resistant Staphylococcus aureus, or MRSA. The number of MRSA-associated hospital stays has more than tripled since 2000, reaching 368,600 in 2005, according to HHS' Agency for Healthcare Research and Quality's (AHRQ) Healthcare Cost and Utilization Project.

Of the $17 million, $8 million will fund a national expansion of the Keystone Project, which within 18 months successfully reduced the rate of central-line blood stream infections in more than 100 Michigan intensive care units and saved 1,500 lives and $200 million. The project was originally started by the Johns Hopkins University in Baltimore and the Michigan Health & Hospital Association to implement a comprehensive unit-based safety program. The program involves using a checklist of evidence-based safety practices; staff training and other tools for preventing infections that can be implemented in hospital units; standard and consistent measurement of infection rates; and tools to improve teamwork among doctors, nurses and hospital leaders.

Last year, AHRQ funded an expansion of this project to 10 states. With additional funding from AHRQ and a private foundation, the Keystone Project is now operating in all 50 states, Puerto Rico and the District of Columbia. The new funding announced today will expand the effort to more hospitals, extend it to other settings in addition to ICUs, and broaden the focus to address other types of infections. Specifically, the new $8 million in funding will provide:

-- $6 million to the Health Research & Educational Trust for national
efforts to expand the Comprehensive Unit-Based Patient Safety Program
to Reduce Central Line-Associated Blood Stream Infections. The funding
will allow more hospitals in all 50 states to participate in the
program and expand the program's reach into hospital settings outside
of the ICU. The Health Research & Educational Trust will also use $1
million to support a demonstration project that will help fight
catheter-associated urinary tract infections.

-- $1 million to Yale University to support a comprehensive plan to
prevent bloodstream infections in hemodialysis patients.


AHRQ, in collaboration with the Centers for Disease Control and Prevention (CDC), also identified several high-priority areas to apply the remaining $9 million toward reducing MRSA and other types of HAIs. These projects will focus on:

-- Reducing Clostridium difficile infections through a regional hospital
collaborative.
-- Reducing the overuse of antibiotics by primary care clinicians
treating patients in ambulatory and long-term care settings.
-- Evaluating two ways to eliminate MRSA in ICUs.
-- Improving the measurement of the risk of infections after surgery.
-- Identifying national-, regional- and state-level rates of HAIs that
are acquired in the acute care setting.
-- Reducing infections caused by Klebsiella pneumoniae
Carbapenemase-producing organisms by applying recently developed
recommendations from CDC's Healthcare Infection Control Practices
Advisory Committee.
-- Standardizing antibiotic use in long-term care settings (two
projects).
-- Implementing teamwork principles for frontline health care providers.

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Employers Support Non-Payment for Hospital-Acquired Infections

/PRNewswire/ -- The non-profit Midwest Business Group on Health (MBGH) released the results of a survey of employers and health care industry stakeholders on their knowledge and intentions to improve the safety and quality of health care by no longer paying for "never events" - serious and costly preventable hospital errors and hospital-acquired infections. The findings were presented at a meeting of key health care industry stakeholders including public and private employers, hospitals, health plans, doctors, consumer organizations and government hosted by MBGH in Chicago last week.

"There are currently several separate efforts taking place in our community aimed at reducing hospital-acquired conditions," said Larry Boress, president and CEO of the MBGH. "We invited key stakeholders to come together for an in depth discussion on "never events" in the hopes that we can bring continuity to these efforts and make faster progress toward improving the safety and quality of health care for everyone."

Survey findings
-- More than 60 percent of employers believed they should pay for
conditions that arose after the covered patient was admitted to a
hospital, if the facility was not at fault.
-- However, once employers became aware that Medicare had identified
conditions which should never happen to a patient and will not pay for
services related to such situations, close to 80 percent of health
care purchasers agreed that their health plans should adopt the same
payment policies as Medicare related to those conditions.
-- Nearly 100 percent of employer respondents indicated hospitals should
refrain from billing patients for services not paid for by their
benefits for events that experts say should not happen in a hospital.
-- Sixty-eight percent of employers agreed that MBGH should bring
together plans, hospitals, employers, consumer and government agencies
to define and address as a community what conditions hospitals should
focus on from the "never events" and Medicare hospital-acquired
conditions lists.


MBGH is a Regional Roll-Out Leader for The Leapfrog Group and is actively involved in hospital performance and public reporting efforts in Chicago, including the Leapfrog Hospital Survey. A section of this survey addresses 28 serious preventable errors or "never events" as set forth by the National Quality Forum (NQF). Currently, less than 47 percent of hospitals in Illinois participating in the Leapfrog Hospital Survey have agreed to meet the Leapfrog "never events" policy. Efforts are also being looked at by national groups to consider payment policies that refrain from paying for such events in physicians' offices.

"Most small- and mid-size employers are unaware of the impact of "never events" to their growing costs for health care," said Joseph Balasa, chief operating officer for the Chicagoland Chamber of Commerce. "We are looking to the large employers, hospitals and health plans to make progress in solving this problem so the entire community can benefit from improved quality and safety of health care."

MBGH's survey and the meeting were supported by sanofi-aventis. The survey was submitted electronically, with more than 50 employers and other health care stakeholders responding. More than 160 people participated in the meeting.

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