Health care-associated infections in hospitals continue to decline

The CDC report on health care–associated infections is great news. It shows that we have been making significant and substantial progress in the often preventable infections that occur in our hospitals. Reductions of 41% (CLABSI) are very impressive. This is a significant number of patients who did not get infected, receive otherwise unnecessary antibiotics and remain in the hospital longer than necessary. This also represents a significant cost savings. As we strive for improved value for our patients – higher quality care at lower costs – improvements like this are amazing.

One interesting finding is that, while there are reductions in CAUTIs and SSIs, they are not as significant as those with CLABSI. I think part of this has to do with the research into CLABSI and the fact that it lent itself well to the use of protocols and checklists, which are easily adopted by institutions. Peter Pronovost’s 2006 New England Journal of Medicine study detailed the 66% reduction in CLABSI throughout Michigan ICUs via the use of a simple checklist. SSIs also lend themselves to "protocol-ization." CAUTIs are slightly more difficult because a different human factor is introduced – the convenience and wishes of the patient. We need to continue educating our patients about CAUTIs and developing protocols that make the early removal of catheters the norm rather than the exception.

Physicians should be proud of their efforts in reducing health care–associated infections. We need to continue working hard to sustain these gains and identify other areas where similar interventions will yield positive outcomes. Sustained education and intervention will get us close to the HHS goals by the end of 2013, if not achieve them outright. One simple method of preventing health care–associated infections is to (a) implement a standardized checklist of proven steps to reduce said infections, and (b) empower members of the health care team to stop the provider when those steps are not being followed. A team approach, both in the development and implementation of these protocols, is essential to initial and sustained success.

Dr. Michael Pistoria is an internal medicine specialist and hospitalist at Allentown Hospital and Bethlehem Hospital in New Jersey. He is a senior fellow of the Society of Hospital Medicine and served as lead editor of the publication "Core Competencies in Hospital Medicine," which defined hospitalists’ roles. He made these comments in an e-mail interview with this news organization.