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PrintA state Department of Health report released Thursday shows that Pennsylvania's hospitals reported their patients contracted 25,914 infections in 2009, an estimated 12.5 percent fewer than a year earlier.
"Though the report seems to show we're making progress, 25,914 is still a very large number and shows we still have our work cut out for us in bringing that number down," Stephen Ostroff, the state's acting physician general, said Thursday. "And there's clearly some hospitals that have more work to do."
Officials had to estimate the difference between the two years, because the figure for 2008 was based on six months of data.
Hospitals in southwestern Pennsylvania did well in the report, as they have in prior state reports, with few area hospitals having more infections than the state projected.
PDF- 2009 Report: Healthcare-Associated Infections (HAI) in Pennsylvania Hospitals
- Non-Technical Summary for Consumers
- See a chart for the 2009 rates of infections in local hospitals.
The state began collecting infection data under a different state agency in 2005, but this report marks the first full-year report from the Department of Health and will stand as the baseline year for hospitals.
Based on this 2009 data, if hospitals do not meet state-mandated goals for infection reduction in future years, starting in 2010, they can face financial and licensing sanctions from the state.
During a news conference to announce the report's release, Gov. Ed Rendell, who pushed for creation of the statewide reporting system, declared the data "encouraging."
"Patients should not have to worry that simply being admitted to the hospital could put them at risk for acquiring a serious but preventable illness," he said. "And curbing [hospital-acquired infections] will go a long way toward controlling the cost of health care."
While state officials were quick to seize on the apparent reduction in infections from 2008 to 2009, infection experts pointed out the state's reporting has its problems.
"You're still going to feel better about the data when it's all audited," said Karen Wolk Feinstein, co-founder of the Pittsburgh Regional Health Initiative, which helped push for the state's first public reporting on infections.
There was no auditing of the 2008 figures. But with the support of some federal stimulus funds, the state will begin auditing select hospitals -- those that have very high rates and those with very low rates of infection -- later this summer, said Stacy Mitchell, deputy secretary for quality assurance for the Department of Health.
Carlene Muto, UPMC's medical director for infection control, said she'd welcome an audit.
"If you're really low, you should be credited, and if you're really high, you might need some help," she said. "I think the audit is a great idea."
But another problem with this year's report, Ms. Wolk Feinstein said, was that it relies on just half a year's data from 2008 to conclude that there is a 12.5 percent reduction in infections.
The Department of Health ran into reporting problems when it first began collecting data in 2008, and only had the last six months of that year to use. To draw the full-year comparison to 2009, then, it extrapolated the 2008 data.
"One needs to take that for what it's worth: It is an extrapolation," Ms. Wolk Feinstein said. "I want to see full-year information."
Hospitals in southwestern Pennsylvania performed well in the report compared to the rest of the state, as they have in past state reporting.
As an example, the state uses a ratio to estimate how many infections each hospital would be expected to have in a year, given its size, services provided and health of its patients.
The state then determines if a hospital had more, less or about what it expected for two of the most common and dangerous type of infections -- catheter associated urinary tract infections and central line associated bloodstream infections.
Of the 32 hospitals across the state that did worse than expected with urinary tract infections, only one -- Allegheny General Hospital -- was from southwestern Pennsylvania. And of 27 hospitals that did worse than expected with bloodstream infections, only three were from the region (Children's Hospital of Pittsburgh of UPMC, UPMC Mercy and Select Specialty Hospital - Pittsburgh).
Allegheny General Hospital was aware of its higher-than expected urinary tract infection rate and over the last year has applied techniques similar to the ground-breaking work it did starting a decade ago to reduce central line associated bloodstream infections, said Sharon Kiely, chief quality officer for the hospital.
"We knew we were struggling with urinary tract infections," said Dr. Kiely, so the hospital began a series of new training techniques and protocols, including not allowing nurses or doctors to insert a central line unless they had been trained in the infection-reducing methods.
While Allegheny General had 161 urinary tract infections -- 53 more than the state expected -- in 2009, earning it a red mark on the state's color-coded chart of hospital data, it got a green mark for only having 22 bloodstream infections, which was 29 fewer than the state expected.
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