Infection Control

In the fall of 2006, the Pennsylvania Health Care Cost Containment Council released a report on the extent and cost of hospital-acquired infections (HAIs) across the state in calendar year 2005. Pennsylvania was the first state to publicly report such information. The findings were stunning: an infection rate of 12.2 per 1,000 hospital cases, leading to over 394,000 infection-related hospital days amounting to hospital charges of $3.5 billion. According to the report, the average commercial insurance payment related to caring for a patient who acquired an HAI was almost $54,000, compared with approximately $8,000 in commercial insurance payments for each patient who did not acquire an infection.*

The Pittsburgh Regional Health Initiative (PRHI) was an early supporter and remains a strong advocate for public reporting stemming from PRHI’s initial quality improvement efforts to address HAIs in southwestern PA. In 2001, PRHI convened a collective work group of infection-control practitioners and infectious disease physicians from 30 Pittsburgh-area hospitals to share best practice ideas for preventing HAIs, specifically central line-associated bloodstream (CLABS) infections. The Centers for Disease Control (CDC) supported this Pittsburgh-focused work, receiving quarterly infection data from the workgroup and publishing central line infection prevention guidelines in 2002.

PRHI had recently launched a new methodology, Perfecting Patient Care (PPC), which drew interest from infection control practitioners in the work group. Through participation in the PPC programming, practitioners learned and applied design principles to work processes, and engaged frontline staff in designing preventive measures to strive for “zero” infections.

Over the course of four years, hospitals engaged in the work group demonstrated a 63% decline in the number of central line infections prompting recognition of the southwestern Pennsylvania's collective to challenge what was possible in the fight against HAIs.