Hospital Acquired Infections and Readmission Rates in PA
Hospital Acquired Infections (HAIs) are infections that patients acquire during the course of receiving
treatment for other conditions within a healthcare setting. HAIs are a leading cause of death in the United
States.
The Centers for Disease Control and Prevention (CDC) estimates that 1.7 million patients contract
HAIs every year and for nearly 99,000 of those patients, the infections are fatal1. Elderly patients acquire
more infections, with the highest rate among those between the ages of 65 and 842.
23,287 patients contracted at least one HAI in the course of a hospital stay in 20092:
Patients who contract an infection while hospitalized in PA2:
• Are six times more likely to die;
• Will stay in the hospital 15 more days on average;
• And receive care that is 5.4 times more expensive.
Hospital Acquired Infections also cause readmissions:
• 40% of patients who contract an HAI at a PA hospital are readmitted within 30 days2
• Surgical site infections were the most common HAI and also had the highest percent of readmissions
within 30 days.
Readmission Rates
Nationally, one in five individuals with chronic conditions are readmitted to the hospital within 30 days
because they went home without adequate information and support 3. In PA, people with chronic
conditions have a 25% readmission rate within one year3.
1Centers
for Disease Control and Prevention (www.cdc.gov/ncidod/dhqp/healthDis/html)
Health Care Cost Containment Council, February 2011
3www.phc4.org/reports/chroniccare/10/docs/chroniccare2010report.pdf
2PA
What is PA doing to reduce HAIs and Readmission Rates?
PA is the first state to explicitly link HAI reporting to prevention…
PA is the only state that reports on all types of HAIs, and evidence shows that this public reporting is an effective
tool for reducing the rate of infections… The overall rate of HAIs in PA decreased by 8% following two
consecutive years of reporting (2008 to 2010)1.
Governor Rendell singed the PA Healthcare-Associated Infection and Control Act (Act 52) into law in 2007:
• Act 52 is the implementation statute for many of the HAI reporting activities
• The Act requires PA Department of Health to receive reports on all HAIs
• Mandatory analysis is completed to assess facility-specific rates and to compare PA rates to other
parts of the country
• PA Department of Health also sets annual reduction targets
PA was the first state to create a patient safety organization…
PA hospitals report serious events and near-miss information to the Pennsylvania Patient Safety Authority, which
reports, analyzes, and makes recommendations on how to improve care and prevent medical errors4.
PA was the first state to develop and implement a Medicaid payment policy…
As of 2008, hospitals, heath care providers, and other facilities in PA no longer receive payments for Medicaid
patients who experience preventable serious adverse events4.
What’s happening in Southwestern PA?
UPMC
→ UPMC created an initiative in 2001 to identify patients at high risk of infection and implement the appropriate
safety measures: these efforts resulted in an 85% reduction of hospital acquired infections5.
→ The Centers for Disease Control (CDC) named UPMC a Center of Excellence and are modeling the practices
to reduce infections in other parts of the country.
VA Pittsburgh Healthcare System
→ Commitment to reducing hospital acquired infections started in 2001 with the Getting to Zero initiative, which
aimed to achieve a 50% reduction in the infection rate by 20066. Key components were added to the initiative
in 2005:
- An aggressive hand hygiene implementation program
- New surgical and dressing change techniques and appropriate use of antibiotics
- Precautions that require health care workers to wear gloves and gowns while treating certain patients
→ Over an 8 month period, the VA saw a reduction in surgical site infections: With the new safety measures,
the VA saw only 2 surgical site infections take place in 8 months6, compared to the prior average of 40.
West Penn Allegheny Health System
→ Piloted the Perfecting Patient Care System in 2003 to improve patient safety in the ICU and coronary
care unit. Upon discovering that femoral IV lines had higher rates of infections than other sites, the health
system implemented new practices to reduce the rate of infections, which fell by 76%7.
→ Implemented best practices such as standardized dressing change kits and antimicrobial dressing with
catheters that remain in past two weeks.
4Hospital
and Healthsystem Association of PA: www.haponine.org
5www.upmc.com/aboutupmc/QualityInnovation/ExcellanceInPatientCare
6www.pittsburgh.va.gov
7www.commonwealthfund.org
Healthy Hospital Initiative
Patients demanding better care at the “Bedside & Beyond”
We can create healthy hospitals. We know how. There are good practices and great models of care, but we’re not
putting them to use everywhere. It’s time to give every patient the best care we can offer.
It starts with every hospital pledging to meet the National Improvement Goals from the Partnership
for Patients:
• No patient gets a hospital-acquired infection
• No patient goes home from the hospital without follow-up care
• Providers, patients, and family caregivers have all the information they need.
We all have to take a stand, and keep fighting until every hospital puts the very best practices in place.
The Campaign for Better Care is fighting for better coordinated, safer care for you and your loved
ones.
Join us- Contact Reverend Sally Jo Snyder at (412) 456-1877 x203 or
ssnyder@consumerhealthcoalition.org
Role of Chronic Conditions
Chronic conditions, like heart disease, diabetes, and high blood pressure, are conditions expected to last at least
one year and often require on-going medical treatment. Nationally, nine out of ten adults over the age of 65
have at least one chronic condition and 77% have multiple chronic condtions.8 Many individuals with chronic
conditions experience harmful drug interactions, duplicate tests, and conflicting diagnoses because our health
care system does not effectively coordinate care.
Chronic Conditions in PA:
- PA has the second oldest population in the country, with more than 1 in every 7 residents over the
age of 658
- Chronic conditions contribute to 80% of all health care costs in PA9
In 2008 alone, the United States spent $2.3 trillion on health care costs, an amount three times greater than in
1990. Over 75% of the total expenditures were on the treatment of chronic conditions8.
Hospitalization and Chronic Conditions:
• Nationally, one in five individuals with chronic conditions are readmitted to the hospital within 30 days
because they went home without adequate information and support9.
• Hospitalizations in PA for asthma, diabetes, COPD, and heart failure were higher than the
national average and increased from 2004 to 2008
• Most hospitalizations for these conditions are preventable with better access to primary care
• PA: People with chronic conditions have a 25% readmission rate within one year
8PA
Department of Health, 2007
9www.phc4.org/reports/chroniccare/10/docs/chroniccare2010report.pdf
PA Campaign for Better Care
Better care starts with safer care and better coordination:
-
That means getting the right medicine, in the right dose, at the right time;
It means doctors and nurses talk to each other about your care, and talk to you about your
choices;
It means your care is coordinated across doctors, specialists, lab, pharmacy, and hospital to
home;
It means you can rely on hospitals to make you and your loved ones better, rather than putting
you at risk.
Consumer Health Coalition (CHC) partnered with Community Catalyst to implement the PA Campaign for Better
Care, a movement to secure quality, coordinated, and patient-centered care in PA. Major focus areas of the PA
Campaign for Better Care are:
• Readmission and Transition Initiative: Set statewide goals to reduce readmissions and hospital
acquired infections
• New Models of Care: Promote Patient Centered Medical Homes and Accountable Care
Organizations, with specific initiatives to address the needs of older adults
• Home and Community Based Services
• Education on the Affordable Care Act (ACA) and defense against repeal efforts
How You Can Get Involved:
→ Contact Reverend Sally Jo Snyder at (412) 456-1877 x 203
or ssnyder@consumerhealthcoalition.org
→ Visit the CHC website at www.consumerhealthcoalition.org and
click on the link to the PA Campaign for Better Care
→ Stay informed
→ Educate and encourage your family, friends, and co-workers to
be informed and involved