New HHS secretary calls for action on HAIs

'I'm challenging hospitals to . . . fight infections.'

Health care-associated infections (HAIs) are clearly on the radar of Kathleen Sebelius, the new Secretary of the Department of Health and Human Services (HHS). She recently called for action to prevent HAIs in praising two new HHS reports on the quality of health care in America.

"Health care-associated infections can make illnesses worse, further debilitate patients who are already struggling and sometimes lead to death," Sebelius recently said in Washington, DC, at a nursing conference.

Published by the Agency for Healthcare Research and Quality, the annual 2008 National Healthcare Quality Report and 2008 National Healthcare Disparities Report indicate that patient safety measures have worsened and that a substantial number of Americans do not receive recommended care. Upon issuing the reports, Sebelius also announced the availability of $50 million in Recovery Act resources to fight health care-associated infections and improve patient safety. "Through the funding provided by the Recovery Act, we can help prevent these infections and improve the quality of care for all patients."

In a finding that will be no surprise to infection preventionists, the quality report underscored that central line-associated blood stream infections (CLABSIs) strike hundreds of thousands of patients each year. Patient safety has declined in part because of this rise in HAIs. Moreover, HAIs are among the top 10 leading causes of death in the United States, and drive up the cost of health care by up to $20 billion per year, the HHS emphasized.

Sebelius announced that the HHS plans to make $50 million in grants funded by the American Recovery Act available for states to help reduced HAIs. HHS plans to make $40 million available through competitive grants to eligible states to create or expand state-based HAI prevention and surveillance efforts, and strengthen the public health work force trained to prevent HAIs. HHS also is allocating $10 million in grants to states to improve the process and increase the frequency of inspections for ambulatory surgical centers.

Endorses use of Hopkins checklist

Sebelius also called on hospitals across America to commit to reduce CLABSIs in intensive care units by 75% over the next three years. Research indicates that these infections strike hundreds of thousands of surgical patients and the percentage of patients acquiring those infections has steadily increased over the past six years, she noted. Sebelius challenged hospitals to make use of a proven patient-safety checklist (developed at Johns Hopkins) to significantly reduce CLABSIs.

"Patients expect to get better in a health care facility, not worse," added Sebelius. "The Recovery Act money will help protect patient safety, but we need hospitals to do more. Today, I'm challenging hospitals to take basic steps to fight infections that are weakening our health care system and threatening patient safety."

In a related development, the Association for Professionals in Infection Control and Epidemiology (APIC) applauded the Obama administration for proposing increases in the HHS fiscal year 2010 budget for public health programs.

"The 'HHS 2010 Budget for a Healthier America' is a fitting follow-up to recent funding bills which clearly show a strong commitment to improve the public's health," said Christine J. Nutty, RN, MSN, CIC, 2009 APIC president. "The FY09 Omnibus Appropriations Act provided $22 million to address health care-associated infections and took much-needed steps toward addressing shortfalls in many chronic disease and environmental health programs. The proposed emergency supplemental bill that is under way would improve our nation's pandemic influenza preparedness."

The FY10 budget also includes a $26 million increase in funding for the Strategic National Stockpile, increases for state and local health departments and hospitals to prepare for public health emergencies, and an increase of $30 million for the Biomedical Advance Research and Development Authority.

(Editor's note: The HHS reports are available at http://www.ahrq.gov/qual/qrdr08.htm. The HHS has posted the CLABSI checklist at http://www.ahrq.gov/qual/clichklist.htm.)