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While highlighting a dramatically expanding national research agenda to prevent health care associated infections (HAIs) a top public health official made a rather counterintuitive point. We already know enough to prevent the majority of HAIs, but the will – the widespread adoption of a true patient safety culture in many health care settings – is the conspicuously missing piece.
“Recent efforts have demonstrated that relatively simple measures can prevent the majority of HAIs,” notes Carolyn M. Clancy, MD, director of the Agency for Healthcare Research and Quality. “However, important strategies to reduce and control infections, such as routine hand hygiene, have not always been adopted or strictly monitored. Adherence to guidelines developed specifically to combat the incidence of specific infections, such as CAUTI and VAP, has been suboptimal (U.S. HHS, 2009, June).”
Suboptimal indeed, but the federal government and consumer advocates all over the HAI problem now – finally – and it appears that in the absence of carrots, there will be sticks. For her part, Clancy has posted a commentary observing that HAIs are “on everyone's hit list.” For example, , national goals call for significant reductions in HAIs, including the Department of Health and Human Services' (HHS) goal of reducing central line-associated blood stream infections (CLABSIs) by 75% percent over 3 years (U.S. HHS, 2009, May).
“For health care organizations, the pressure is mounting to reduce and prevent HAIs, among the leading causes of preventable death in the United States. HAIs—infections that patients acquire during medical treatment or surgical procedures—infect nearly 2 million patients, contribute to 99,000 deaths, and cost as much as $33 billion each year (Klevens et al., 2007; Scott, 2009),” she writes.
The increased scrutiny on HAIs comes from stepped-up public reporting efforts, increased focus from accreditation bodies, and greater accountability among payers. For example, Medicare has stopped paying hospitals for the additional costs associated with certain hospital-acquired conditions, including vascular catheter-associated infections.
“Protecting patients from HAIs is an increasingly wise business decision for organizations, in addition to being in patients' best interests,” Clancy said. “…[H] hospitals and other health care organizations don't have to wait to improve their HAI prevention efforts. The knowledge, tools, and resources are available now for organizations to make major progress in reducing rates of HAIs in their facilities.”