CACC

Cynthia Bascetta, director for Health Care Issues in the Government Accountability Office, charged a lack of coordination between the Agency for Healthcare Research and Quality (AHRQ), Centers for Disease Control and Prevention (CDC), and Centers for Medicare and Medicaid (CMS), and further claimed there was no one in the Secretary of HHS' office in charge of tracking HAIs.

Other key statements, charges and proposals made during the hearing included the following:

Leapfrog called for federal agencies to see HAIs as a priority and tie payments to positive outcomes, rewarding hospitals for voluntary efforts.  Further, the agency called for HHS to provide more authority for value-based purchasing.

HHS reported an AHRQ initiative to mitigate infections at 72 hospitals, and stated that the CDC is modifying its HICPAC recommendations to address MRSA.

Dr. Peter Pronovost, medical director, Center for Innovation in Quality Patient Care, and assistant profession for Johns Hopkins' School of Medicine Department of Anesthesiology and Critical Care Medicine, said the issue of HAIs should be approached as a science, not an art.  He cited examples of Ventilator-Associated Pneumonia for which there are 30 false-positives for every correct diagnosis, adding that it is important to make things simpler, e.g. providing a checklist instead of 200 pages of guidelines.

In response to questions from Washington D.C. Delegate Eleanor Holmes Norton, it was noted that HHS is working with Walter Reed Hospital to address the risks associated with the treatment for acinetobacter in soldiers.

Betsy McCaughey of the Committee to Reduce Infection Deaths (RID), charged a lack of cleanliness in U.S. hospitals, blaming the CDC as a result of changes in the 1970's in which there was no longer strict oversight over the cleanliness of hospitals.  She claimed that restaurant cleanliness standards are far greater than those for hospitals and called for expanded reporting of 25 adverse events as defined by the National Quality Forum.
 
Dr. Pronovost called for the same approach to HAIs as was taken with polio, agreeing with Congressman Paul Hodes that addressing HAIs was "low-hanging fruit" in healthcare reform.  Congressman Hodes asked the HHS to consider eliminating silos and to create the synergy needed to move the HAI issue forward.

Congressman Timothy Murphy of Pennsylvania, author of the Healthy Hospitals Act, stressed the importance of online information regarding HAI data, contrasting the ready access consumers have to online information on airline flight schedules, to that of information on HAI rates which is more limited. 

Congressman Murphy also asked each witness whether there needed to be federal action to make information on HAIs publicly available and whether we should act quickly.  Witnesses responded in the affirmative, but there were comments that reporting needed to be thoughtful and coupled with funding on preventing infections, rather than just reporting on them.

The Department of Health and Human Services has sixty days to respond to the GAO report.  In the meantime, as Members of Congress take action to respond to the concerns of their constituents, or to have a positive action on healthcare just prior to an election year, APIC will reinforce the importance of science-based requirements that improve patient health, rather than legislation that produces sound bites, with little corresponding benefit to patients.
  
To access the archived video of the hearing click here.