More than 30,000 Americans die each year from completely preventable blood stream infections acquired at hospitals. In Florida, 22 intensive care units have reduced the incidents of those infections to zero, according to the Florida Hospital Association.

 

The results came thanks to a renowned program led by Peter Pronovost, MD, a professor at Johns Hopkins University’s Quality and Safety Research Group, who says hospitals and physicians should be doing more.

 

Pronovost, who created the Stop BSI campaign (www.safercare.net), spoke at the annual conference of the Association of Health Care Journalists in Chicago on April 24.

 

“What other industry would be tolerated that kills 31,000 people nationally every year,” Pronovost said. “Our ego and arrogance (as physicians) keeps us from participating and has to end. We need to work to rally and make this the polio campaign."

 

Yet fewer than 20 percent of hospitals in most states are participating, Pronovost said. In Florida, the program was offered as a grant to 34 intensive care units at 18 hospitals and is now open to all hospitals, said Bruce Rueben, president of the Florida Hospital Association.

 

“Anytime you have best practices that are known from research or experience, in this case to reduce blood stream infections, then they ought to be embraced and incorporated into the way hospitals deliver care,” Rueben said. “That way, we reduce problems and we have better outcomes and reduce the costs of care.”

 

Rueben said the association is working with the American Hospital Association and the Agency for Healthcare Research and Quality to coordinate processes between hospitals so when bedside nurses and physicians move from one facility to another, checklists and procedures are the same.

 

These are proven strategies to reduce harm. In Michigan, 100 intensive care units have used the Stop BSI program guidelines of checklists, verified reporting and patient safety measures to eliminate blood stream infections for the past four years.

 

Widespread adoption of similar best-practice “bundles” put out by the Institute for Healthcare Improvement for a wide range of procedures has helped efforts. But a recent report by the Agency for Healthcare Research and Quality also suggests hospitals need to do more. An analysis of medical errors and patient safety in hospitals nationwide found little to no improvements despite increased attention over the past 10 years, according to the ARHQ report.

 

From what limited information the public has on hospital-acquired infections within the Sunshine State – available at FloridaHealthFinder.gov – evidence suggests Florida hospitals could stand to improve as well.

 

In 2005, the state became one of the first to publicly report hospital-specific rates of infection. And since then, the legislature has never asked for a progress report and there’ s little way of knowing whether hospitals are improving at reducing infections, according to Beth Eastman, administrator of the Florida Center for Health Information and Policy Analysis.

 

A change in the way the reporting guidelines now distinguish infections that patients may have had upon admission has made it impossible to measure progress, Eastman said.

 

“Until that’s been in our data, we haven’t done a strong look at what’s happened so far,” she said.

 

Today the website lists five surgical site infections and a general category of infections due to medical care with most grades coming in “As expected” with little more information. The reports do not include the number of cases or the most common blood stream, urinary tract or ventilator-assisted pneumonia.

 

At Tampa General Hospital, which is not part of the Pronovost program but uses the nearly identical IHI bundle, they too report improvements, said Peggy Thompson, director of infection prevention.

 

In 2006, the hospital formed a group of intensive care nurse managers and clinicians in what they call their Target Zero committee to go after the most harmful and preventable infections. A year after the group formed, the hospital reduced MRSA surgical site infections 40 percent, Thompson said.

 

Along with SSIs, the group put an increased focus on other leading infections caused by blood stream and urinary catheters and ventilator associated pneumonia.

 

It hasn’t reduced the incidents completely to zero. “But we’re pretty darn close,” Thompson said. “We’ve got units that have gone over a year with no cases of ventilator assisted pneumonia. We’re treating those incidents pretty much like sentinel events.”

 

Last year, Health and Human Services Secretary Kathleen Sebelius called on all U.S. hospitals to reduce blood stream infections from ICUs by 75 percent over three years. The effort would save close to $3 billion and as many as 60,000 lives per year, she said.

 

“No one is accountable for these deaths,” Pronovost told the crowd of healthcare journalists gathered in Chicago. “We know people are dying needlessly. We need to accept responsibility and not pass the buck. No one has publicly apologized for these deaths and we need to see some apologies.”

 

Pronovost called for CMS to post all hospital-specific infection rates on the Internet. “We need to destroy the myth that we're perfect,” he said.