Friday, August 15, 2008

The Coming Wave

This article sent chills down my spine. It's an op-ed piece in the Wall St Journal written by a former lieutenant governor of New York state. And it's just frightening.

Here's a few choice tidbits:
Hospitals being sued are saying that their infection rates are within national norms. But for most infections, the only acceptable rate is zero.

Hospital infections will cause the next wave of class-action lawsuits, bigger than the litigation over asbestos

No wonder Medicare calls these infections "never events." Why should jurors reach a different conclusion in a lawsuit?

Thanks to White Coat for the link.


Anonymous said...

We need to field more cross-industry "field trips" to bridge the widening chasm between professionals in medicine and those in other sectors; otherwise such vicious yet misplaced remarks will only linger on with increasing ferocity. How else would policy makers know that 0.00% infection rate is not possible even if you quarantine everyone in bubbles?

Anonymous said...

To answer your question, Washington, reading the medical literature would be a good beginning.

pinky said...

Wow. This just keeps getting better and better.

Anonymous said...

i believe policy makers in Congress and those in financial sector do have good access to JAMA and NEJM, but not first hand insight.

Gary M. Levin said...

some additional quotes from the article
"This verdict should send a warning to physicians, hospitals and hospital board members. Until recently, infection was considered an unavoidable risk. But now there is proof that nearly all hospital infections are avoidable when doctors and staff clean their hands and rigorously practice proper hygiene and other preventive measures."

Where is the proof??

Some of the evidence....

Obviously applies only to a very limited area of indwelling lines.
Nothing about abdominal sepsis, or other operative problems.

The evidence justifying Medicare's new policy is compelling. Central line bloodstream infections, caused by the contamination of certain devices, are preventable. Hospital patients in intensive care are commonly medicated through a tube inserted into a vein. The risk is that bacteria will invade the tube and enter the bloodstream. Rigorous hygiene, including clean hands, sterile drapes, and careful cleaning of the insertion site with chlorhexidine soap, can keep bacteria away from the tube.

Beth Israel Medical Center in New York City reports that it hasn't had a central line bloodstream infection in the cardiac intensive care unit in over 1,000 days. Dr. Brian Koll, chief of infection control there, explains that the key is using a checklist that doctors and nurses must follow. Implementing the checklist cost $30,000 and saved $1.5 million in treatment costs. Lives saved: priceless.

Other hospitals -- from Johns Hopkins Medical Center in Baltimore to Sutter Roseville Medical Center in Sacramento -- have reached the goal of zero central line bloodstream infections. No wonder Medicare calls these infections "never events." Why should jurors reach a different conclusion in a lawsuit?

We have the knowledge to prevent infections. What has been lacking is the will. A recent survey from the patient-safety organization Leapfrog found that 87% of hospitals fail to consistently practice infection prevention measures

Anonymous said...

Health train express is wrong, and the misreporting of the evidence is a clear example of the disconnect brought up by other commentators. Beth Isreal does not have a 0% central line infection rate as clearly demonstrated on their own site:

Even their lowest rate to date still has them with 38 line infections over their denominator period. The key reporting item is that none of these infections have been in the CCU. While this is certainly admirable, it is also highly misleading to take a sample of the whole and then claim that it represents the whole.

Anonymous said...

That should be 0.38 not 38.

Jeffrey Parks MD FACS said...

Yeah, I wasn't sure what Health train was geting at. He basically carbon copied the article that I already linked too....

Thanks for the clarifications anonymous.

Anonymous said...

How many times do we have to read these "next wave of lawsuits" stories that never happen before people quit believing in these scare tactics?