Pennsylvania reports drop in hospital infections, other patient care issues include CT scans

The Pennsylvania Department of Health found that 12.5 percent fewer patients contracted infections in the state's hospitals in 2009 than a year earlier, according to the Pittsburgh Post-Gazette. But the reports shows that there were 25,914 infections in 2009. "'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. ... Officials had to estimate the difference between the two years, because the figure for 2008 was based on six months of data. ... 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" (Hamill, 6/25).

The Philadelphia Inquirer: "Those with high infection rates included some of the city's most storied hospitals, such as Children's Hospital of Philadelphia and the Hospital of the University of Pennsylvania. Executives at both institutions said they had made progress since 2009, the year the report focused on. And experts cautioned against using the report to compare hospitals, because the methodology to track infections is evolving. … One issue is that Philadelphia is home to many large academic medical centers that treat the most complex problems, said Kate Flynn, president of the Health Care Improvement Foundation, a nonprofit that works with local hospitals to boost patient safety" (Goldstein, 6/25).

The (Doylestown, Pa.) Intelligencer: "Overall, most of Pennsylvania's 250 hospitals met the state's 2009 infection rate expectations in the two categories" of two kinds of urinary tract and blood stream infections and life-threatening infections (Ciavaglia, 6/25).

In other news coverage of patient care issues, Kaiser Health News has a Q&A with Professor Kate Lorig, who directs the Patient Education Research Center at Stanford University on chronic disease and ways to treat the "whole" patient. Lorig said that right now, the health care system "addresses diseases or even parts of diseases or small sub-parts of the body. It does not address the whole, complex person with multiple chronic diseases. So, right now, what happens, if you're lucky, you go to a primary care doc who kind of does the day-to-day stuff and then you see four or five specialists each of which do their little specialty part — none of whom really talk to each other except maybe to look at your laboratory tests on an electronic medical record if you're really lucky. It is totally uncoordinated. It's chaotic. It serves pieces of people, not whole people" (Marcy, 6/25).

Reuters reports that experts also are trying to decide how to protect patients from radiation, and while one expert says the Food and Drug Administration should step in, others say the FDA should stay out. "Both sides of the debate, published on Wednesday on the New England Journal of Medicine website, reflect ongoing concerns about how to best use advanced diagnostic tests. Overuse of the costly scans has been a concern of policymakers for the past few years, prompting cuts in Medicare reimbursement. And recent studies on radiation risks from computed tomography or CT scans and several cases of accidental radiation overdoses have drawn the attention of the FDA" (Steenhuysen, 6/24).

NPR's Shots Blog also reported on NEJM and CT scans: "radiologist Bruce Hillman and health policy guru Jeff Goldsmith argue for more thoughtful use of scans on economic and clinical grounds. The explosive growth in the number of scans has come at an enormous cost. 'There is broad agreement that an unknown but substantial fraction of imaging examinations are unnecessary and do not positively contribute to patient care,' they write. So, they ask the medical community to look inward and figure out how to change the culture" (Hensley, 6/24).