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Infection Control

So much has been written about the 100,000 people who die each year from hospital-acquired infections that by now we’re almost numb to the statistic. Not that senior leaders don’t care about dying patients, because they do. But like many clinical issues, HAIs are usually left to departments like infection control and patient safety to address. What most hospitals have missed until recently, however, is that HAIs affect more than patient safety—they cost hospitals money. Lots of it.

Reports have estimated that HAIs extend hospital stays by an average of 16 days and increase costs by close to $150,000 per patient. A Massachusetts state report released this summer estimated that infections contracted during hospital stays cause up to $473 million in medical costs each year in that state alone.

Several states have made the reporting of HAI rates mandatory, and other states are expected to adopt similar rules. As stricter regulations are enforced, analysts predict a growing pressure on hospitals to screen all high-risk patients—even if they don’t exhibit symptoms. Some hospitals balk at this idea, saying they don’t have the resources to comply. But senior leaders at health systems who have done it say hospitalwide surveillance means fewer infections down the line, and it actually saves resources (not to mention lives).

Take HCA, Inc., for example. HCA has adopted a systemwide surveillance system for MRSA, a staph infection resistant to typical antibiotics. HCA clinicians screen every patient who’s at risk for one of these infections (most facilities screen patients only after they show symptoms—often too late to prevent the infection passing to someone else). While this practice is unusual and even controversial (it costs time and money), Jonathan Perlin, MD, HCA’s chief medical officer and senior vice president of quality, says it’s worth it. This policy is about more than patient safety; Perlin calls it a “rational business decision.” So important to business, in fact, that HCA’s senior leaders actively participate by conducting weekly scripted walkarounds to ensure that the process is happening. If it’s not, offenders are “ticketed” with a formal letter reinforcing the policy. Senior leadership’s involvement is key to the success of HCA’s program, Perlin says.

HCA aside, hospitals are a long way from solving the problem of HAIs. Eradication is going to take much more than hand-hygiene posters and disinfectant; it’s going to take involvement by the C-suite. If you haven’t made HAIs a top item on your priority list, you should—before your state forces you to.

—Molly Rowe