Hospitals must publicly report infection rates, experts say

The federal government’s move to target the superbug MRSA is a great start but hospitals should take it a step further by publicly reporting their infection rates, patient advocates and experts say.

“I’m still stuck on the idea that their plan has to include public reporting,” said Michael Gardam, director of infection prevention and control for the University Health Network. “We’re going around telling people that this is a really significant health issue but we’re not going to tell you how bad it is. In my mind, it has to happen.”

While the network’s teaching hospitals of Toronto General, Princess Margaret and Toronto Western have publicly reported three types of infection rates over the past three years, including that of methicillin-resistant Staphylococcus aureus, few hospitals do.

And yet, in the United States, 18 states now require hospitals to publish their infection rates.

An estimated 220,000 Canadians develop hospital-acquired infections each year, of which MRSA is one type, according to Canadian Nosocomial Infection Surveillance Program figures. About 8,000 people die of nosocomial or hospital-acquired infections annually.

Yesterday, Ryan Sidorchuk, patient safety champion of the World Health Organization, described the federal move as “one of the few truly national campaigns.” However, the Winnipeg-based patient advocate said he would like to see provincial government funding of hospitals tied to the public reporting of infection rates.

“For me, it would be: if you report, you continue to be funded but if you continue to hide these statistics, your funding will be affected,” said Mr. Sidorchuk, also a member of the Patients for Patient Safety Canada, a group affiliated with the WHO and the Canadian Patient Safety Institute.

In the meantime, he says hospital patients should ask doctors, nurses, other health-care workers and visitors to wash their hands – a move he described as “uncomfortable and awkward” but necessary.

The Montreal-based Association to Defend Victims of Nosocomial Infections, has also called for hospitals to post their infection rates, screen patients for superbugs and financially compensate the thousands of Canadians infected by them.

MRSA has made significant inroads in Canada, where the rate of those colonized and infected over the past decade has increased tenfold. Some of the highest rates have been noted in Quebec and Ontario, according to the Canadian Nosocomial Infection Surveillance Program study, which looked at MRSA in nine provinces.

MRSA can hide inside a nostril, on a hand or in soiled clothing. Symptoms can vary from a blotch of reddened skin treatable with a topical antibiotic to blood poisoning, decayed lungs, or infected heart valves.

Superbugs are such a concern that the Canadian Council on Health Services Accreditation is compelling virtually all acute-care hospitals – in addition to those nursing homes and other institutions seeking a stamp of approval – to provide the rates of MRSA or Clostridium difficile. The requirement, which took effect last month, requires those organizations to also track the rate of either bacterium as part of the accreditation process. Patients will not find themselves enlightened as the figures do not have to be publicly reported.

Yesterday, Wendy Nicklin, president and chief executive officer of the Canadian Council on Health Services Accreditation, applauded the federal government’s effort to improve patient safety.

“Infections will always be here, I think that’s a reality,” Ms. Nicklin said. “But the question is can we do a better job in both prevention and then monitoring.”

Pamela Fralick, president and chief executive officer of the Canadian Healthcare Association, welcomed the federal move, saying the “consistency and uniform approach is what everyone is looking for.”

As for public reporting of infection rates by hospital name, Ms. Fralick said that issue is “critical and needs discussion.”

She also said patients, hospital visitors and health-care workers need to understand why proper hand hygiene is so important, adding that the key to reducing infections is not about “major discoveries and machinery and diagnostics, it’s about hand washing.”

MRSA infections can be significantly reduced through proper hand hygiene, yet only 40 per cent of Canadian health-care workers properly wash their hands.

 

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