Top IC groups draft infection rate law
APIC, SHEA, IDSA issue template for state laws
The nation’s leading health care epidemiology groups have crafted model state legislation for infection rate disclosure laws to ensure ICPs have a leading voice in the process.
States developing such laws should form advisory panels that include "individuals with experience in such disciplines as health care, infection control, and epidemiology to study and to devise methods for health care facilities to track and to report the occurrence of health care-associated infections," according to the model legislation.
"We felt it was very important to include that in the legislation so ICPs can have a voice at the table," says Shannon Oriola, RN, chairwoman of the public policy committee at the Association for Professionals in Infection Control and Epidemiology. Joining APIC in creating the template were the Infectious Diseases Society of America (IDSA), and the Society for Healthcare Epidemiology of America (SHEA).
The model legislation is designed to assist patient safety initiatives by giving state legislatures a template to use when adopting legislation for the collection and reporting of health care-associated infection rates. The hope is that legislation will require recommended practices that have been shown to reduce the risk of health care-associated infections, protect the confidentiality of medical records, and reflect the fact that some institutions treat more seriously ill patients.
"States need a good model on which to base their systems," suggests Martin Blaser, MD, president of IDSA. "It’s important that public reporting be done in a way that allows people to discern what the data actually mean, and — just as importantly — how the data can be used to prevent infections and improve patient care."
Consumers Union, an advocate of infection rate disclosure laws and publisher of Consumer Reports, has been circulating model legislation on the issue for some time. "Consumers Union continues to approach state legislatures on this topic and have a mode bill which has been introduced," Oriola says. "[Our] legislation is based in science and is meaningful to the consumer."
Indeed, the model bill essentially codifies guidelines issued by the Centers for Disease Control and Prevention’s Healthcare Infection Control Practices Advisory Committee (HICPAC). For example, the specific provision to include health care epidemiologists in the process was taken directly from the HICPAC guidelines. Similarly, legislatures considering such a bill are referred to the HICPAC indicators and process measures designed to yield the most meaningful data.
"SHEA, IDSA, and APIC through their memberships have distributed this model so the people on the ground — so to speak — can actually take this to their legislatures," Oriola says. "Let’s hope that an ICP or ID physician armed with this document and with the HICPAC guidance can put language in that is meaningful for reporting data to the public."
Meanwhile, the National Quality Forum continues to move forward in the development of a comprehensive national consensus standard for the public reporting of infection. However, with finalization of that project well down the road, the idea was to get something out in case state legislatures want to enact their own bills. At least six states (Florida, Illinois, Missouri, New York, Pennsylvania, and Virginia) now have laws mandating public reporting of infection rates, and one state (Nevada) mandates reporting infection rates to the state government. Similar proposals have been introduced in about 20 other states.
"States are moving forward quite rapidly," Oriola reports. "We are waiting for the national standards to come out but some states don’t want to wait. Legislatures are all different and they have their own agendas. This [template] is generic and it allows states to really determine what is important in their state. A national standard will really have to have the same outcome and process indicators across the board."