I am writing today to announce the closure of the New Mexico Independent. After three and a half years of operation in New Mexico, the board of the American Independent News Network, has decided to shift publication of its news…
While environmental activists played their part yesterday during demonstrations at the capitol building, going so far as to dress up as solar panels and to sing the tune of “You Are My Sunshine,” their counterparts, the anti-cap-and-trade contingency who has…
Roughly one quarter of University of New Mexico students are unimpressed with the state’s flagship public school, according to a survey that questioned college students about their higher education experiences.
Unlike some states, including Colorado, New Mexico has no law requiring hospitals to publicly report rates of hospital-acquired infections, despite the recommendations of a 2009 Healthcare-Associated Infections Advisory Committee report.
The lack of public disclosure, supporters of such openness say, means that New Mexicans don’t have a way to measure the quality of care they receive at the state’s medical facilities.
The authors of the 2009 report recommended that such reporting be required in the future, even counseling New Mexico officials to look to other states for guidance on how to write legislation to accomplish that.
But so far there hasn’t been an all-out push to require such public disclosure even as other states are moving in that direction.
Nineteen incidents of hospital infections associated with a central line (similar to an IV), were recorded at six New Mexico hospitals from July 1 2008 to May 31, 2009, according to a 2009 state report. Those are infections that patients didn’t have when they came into the hospital.
We know about the 19 incidents because six hospitals– three from Albuquerque and one each from Alamogordo, Las Cruces and Farmington — volunteered the information to the Department of Health as part of a pilot program.
The rate of so-called central line-associated hospital infections at the six participating hospitals was lower than national rate, the report says. But it wasn’t clear where the incidents took place. The incidents were reported in the aggregate, and not assigned to the facility where they happened. Such infections are dangerous and can lead to death in some cases, the 69-page report notes.
Even supporters of public disclosure of such infection rates acknowledge they’d have a big fight on their hands if a big push came to require hospitals to share such data with the public.
“I would support opening this up to the public, but do you want you to spend your time having a fight with them about reporting this to the public or work with them on improving best practices?” Sen. Dede Feldman, D-Albuquerque, told The Independent. Feldman sponsored legislation that created the advisory committee that created last year’s report.
“With no money, I think the answer is clear. I am working with them but we need to find out how far they are going on this important measure of health care quality,” Feldman said.
Federal funding helps expand monitoring
Since New Mexico’s 11-month pilot program, 15 New Mexico hospitals, up from the original six, are expected to share data on central line-associated hospital infections this year, thanks to an infusion of $1.5 million in federal stimulus dollars.
The federal money has allowed health officials to expand monitoring central line-associated bloodstream infections beyond adult Intensive Care Units to pediatric ICUs at the 15 participating hospitals, Dr. Joan Baumbach said via e-mail Tuesday.
Baumbauch is an epidemiologist and is the infectious disease epidemiology bureau chief for the state health agency.
The data on infection rates during the 2008-2009 pilot program came from only adult ICUs at the six hospitals.
The federal money also may prompt New Mexico to add another category to its hospital-reporting regimen. Participating hospitals now report two events: the central line-associated bloodstream infections; and the number of health care workers who are vaccinated against influenza.
About 55 percent of health care workers at the six participating hospitals during the pilot program got flu shots, important for reducing the possibility that patients will get the flu at the hospital.
Approximately 36,000 deaths and over 200,000 hospitalizations occur annually in the United States from influenza and influenza-related causes, according to the report.
The question, along whether this data should be required to be publicly reported, is what happens to New Mexico’s program once the federal money runs out at the end of calendar year 2011.
“I don’t know if we have any money to do this,” Feldman said of state funding.
A spokeswoman for the state health agency said Tuesday that the department would do its best to continue the program.
“We are committed to trying to prevent health care associated infections, and we’ll continue the program as best we can when we no longer have federal funds,” said agency spokeswoman Deborah Busemeyer.
National movement pushes hospitals to become more transparent
The move to tamp down on hospital infections has dovetailed with a national movement for medical facilities to become more transparent about the quality of care they provide patients.
The movement got much of its impetus from a 1999 Institute of Medicine (IOM) report “To Err is Human,” which estimated that up to 98,000 deaths and hundreds of thousands of injuries occur annually in the U.S. because of medical errors and infections.
Meanwhile, early results from hospitals with active surveillance programs, including at Veterans Administration facilities, have shown marked reductions in different types of infections – the invasive MRSA infections. That heightened surveillance is accompanied by a campaign to improve medical practices, including checklists that exhort health care professionals to wash hands more often and disinfect the patient’s skin before attaching a central line to a patient.
Beyond improving quality of care, such reductions in infection rates lower medical costs, patient advocates and others have insisted. Some medical researchers estimate that hospital-acquired infections add billions of dollars a year to health care costs because it lengthens patients’ time in ICUs.
With all that in mind, some states have begun to require public disclosure of everything from “adverse events” at hospitals – where people get sick or die due to medical errors — to hospital-acquired infections and vaccination rates.
Consumer Reports recently released a list of the best and worst performing hospitals as measured by the number of central line-associated hospital infections in their ICUs from 10 states that disclose such data, including Colorado.
Colorado is one of the states the authors of the 2009 New Mexico report pointed to as having a potential model for future legislation requiring public reporting of hospital infection rates.
Colorado requires hospitals and their units, as well as ambulatory surgery centers and dialysis treatment centers, to report “health facility-acquired infections data as a condition of their state licensure,” the 2009 report noted.
Tennessee also was another state held up as a potential model for New Mexico. That state requires facilities with so many inpatients or outpatients to join the National Healthcare Safety Network, which reports health care-associated infection rates from 2,200 hospitals across the country.
New Mexico makes progress in reducing hospital infections
Before New Mexico’s 11-month pilot reporting program, no New Mexico hospital had enrolled in the national health care safety network, the report noted.
There was also a drop in the number of central line-associated bloodstream infections from the first six months of the pilot at the six hospitals – 13 – compared to six events over the final five months of the pilot program.
The authors noted:
“While not statistically significant, the apparent decrease in CLABSI events did prompt discussion among the pilot hospitals. Several questions were posed to determine if any quality initiatives had been instituted or changed during the 11 months of data collection that could account for a decline.”
Five of the six hospitals that participated in the pilot reported that they had changed policies and increased educational in-services during the pilot program to reduce central line-associated bloodstream infections, noted the report.
