State Disclosure Reports

Laws and Legislation

• State Hospital Infection Disclosure Laws (5/09)
  Summary of state laws as of May, 2009. (May 15, 2009)
• Congressional Legislation 111th concerning hospital infections
  Congressional Legislation 111th concerning hospital infection reporting and antibiotic resistant (MRSA) infection detection and prevention (June 24, 2009)
• MRSA screening bill pushed in Congress
  CU endorses bills in Congress to screen patients for MRSA and report infection rates to public (June 24, 2009)
• 2009 State Legislation
  This chart details hospital infection reporting and other patient safety bills being considered by state legislatures in 2009. (March 1, 2009)
• State Hospital-acquired infection public reporting and MRSA prevention bills under consideration in 2008
  This chart details hospital infection reporting bills being considered by state legislatures in 2008. Twenty one states have laws that require public reporting of infection rates. (February 27, 2008)
• Legislation, 110th Congress (PDF)
  Hospital-acquired infection public reporting bills and antibiotic resistant protection and prevention bills under consideration in Congress. (November 26, 2007)
• Hospital-acquired infection public reporting bills under consideration in 2007
  This chart details hospital infection reporting bills being considered by state legislatures in 2007. Twenty one states have laws that require public reporting of infection rates. (May 22, 2007)

Research and Reports

• Consumers Union Report: Cutting Surgical Infections

  Look up your hospital's record on preventing surgical infections. Link to the CU analysis: http://www.safepatientproject.org/cutting_surgical_infection.pdf
  Source: Consumers Union; April (2009)

• Reduce Your Risk of Infection Before an Ambulatory Procedure

  Advice for preventing infection at an ambulatory facility.
  Source: Association for Professionals in Infection Control and Epidemiology (April 2009)

• 15 Steps to Prevent Infections in Hospitals

  Printable pocket guide prepared by Nile's Project.
  Source: Nile's Project

• MRSA Fact Sheet (PDF)

  Informational flier prepared by the Centers for Disease Control and Prevention
  Source: Centers for Disease Control and Prevention

• State Laws Relating to Hospital-Acquired Infections

  Twenty-six states have enacted some form of reporting law, requiring hospitals, and sometimes other health care facilities, to submit infection data to the state or the Centers for Disease Control, and release this information to the public on the Internet.
  Source: National Conference of State Legislatures (2009)

• Rehospitalizations Among Patients in the Medicare Fee-for-Service Program

  A study of Medicare hospital records from 2003 and 2004 found that 1 in 5 patients was readmitted within 30 days, and half of non-surgical patients were rehospitalized without having seen an outpatient doctor in follow-up. In 2004 Medicare paid $17.4 billion to hospital for these readmissions. Readmissions are often avoidable and connected with problems in the hospital (like an infection) or with aftercare.
  Source: New England Journal of Medicine (April 2, 2009)

• Testimony in support of MRSA reporting bill (PDF)

  Testimony on MRSA bill to the Senate Finance Committee considered by the 2009 Maryland General Assembly.
  Source: Michael Bennett (March 2009)

• Report: The Direct Medical Costs of Health Care Associated Infections in US Hospitals and the Benefits of Prevention

  According to the CDC, the overall annual direct medical costs of hospital acquired infections to U.S. hospitals ranges from $28.4 to $33.8 billion.
  Source: March, 2009; Center for Disease Control and Prevention

• Adverse events in hospitals: Overview of key issues

  Department of Health and Human Services, Office of Inspector General report on issues ranging from public and confidential reporting of adverse events, variations in estimates of adverse events, underreporting, measurements and nonpayment policyies for adverse events.
  Source: December, 2008

• Medicare Nonpayment for Hospital Acquired Conditions

  On February 8, 2006, President Bush signed the Deficit Reduction Act of 2005 (Pub. L. 109-171) (DRA) which contained language creating a system for quality adjustment of Medicare payments for inpatient hospital services. The law required the Secretary of Health and Human Services (HHS) to identify at least two hospital-acquired conditions which could have reasonably been avoided through the application of evidence based guidelines and would be subject to the adjustment in payment.
  Source: National Conference of State Legislatures

• HHS National Action Plan to Prevent Healthcare-Associated Infections

  Following last year’s GAO report on the federal response to hospital-acquired infections, the US Department of Health and Human Services has produced a “National Action Plan to Prevent Healthcare-Associated Infections.” The federal agency is seeking public comments on the Plan, due 2/6/09.

• GAO report on hospital infections related to medical devices (PDF)

  The GAO determined the scope and collection of available data limited the agencies ability to determine a national estimate of hospital associated infecdtions related to medical devices. However, experts report medical staff practices as a significant factor.
  Source: (Sept. 26, 2008)

• Infection Control

  Trends in Health Care: Zeroing in on infection prevention and control. The report also links to tables with data from a joint survey of hospital employees conducted in 2008 about most effective methods hospitals use to measure and enforce hand hygiene compliance.

• National Healthcare Safety Network (NHSN) report on 2008 hospital infection data

  This report is a summary of hospital associated infection data collected by NHSN from 2006-2007. Data was collected on device and procedure associated infections reported by participating hospitals. No individual hospitals are identified.

• New study released on prevalence of C-difficile

  New national study finds prevalence of C. difficile infections in hospitals 6.5 to 20 times higher than previous studies. Most are identified as health care acquired, indicating hospitals and nursing homes need to do more to stop the spread of these infections. Consumers Union's policy brief (PDF)explains the problem.
  Source: Association for Professionals in Infection Control and Epidemiology, Inc. (November 2008)

• A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals

  A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals puts existing guidelines and clinical experience into a more practical format that is more useful to health care workers and hospital staff and can help hospitals design comprehensive infection control programs. The compendium covers surgical site infections, central-line-associated bloodstream infections, catheter-associated urinary tract infections, ventilator-associated pneumonia, MRSA, and Clostridium difficile.

• GAO study of infection-reporting methods

  An Overview of State Reporting Programs and Individual Hospital Initiatives to Reduce Certain Infections.
  Source: (October 2, 2008)

• Potentially Deadly Infection Doubles Among Hospital Patients Over Last 5 Years

  The Agency for Health care Research and Quality report finds disturbing trends in c.difficile infections, which can lead to diarrhea, blood poisoning and death.

• Hearing video: Healthcare-Associated Infections: A Preventable Epidemic

  Hearing of the Committee on Oversight and Government Reform, Chairman Henry A. Waxman.
  Source: April 16, 2008

• GAO Report: Federal Response to Health Care Associated Infections

  Health-Care-Associated Infections in Hospitals: Leadership Needed from HHS to Prioritize Prevention Practices and Improve Data on These Infections.
  Source: April 16, 2008

• Catheter chaos: Most hospitals are failing to follow proven strategies to prevent urinary tract infections

  University of Michigan survey reveals that hospitals don’t have a consistent strategy for dealing with urinary catheters or ensuring their timely removal
  Source: University of Michigan Health System (January 3, 2008)

• Health Guide: MRSA Infection

  Background information on causes, symptoms, treatment, and other resources
  Source: New York Times

• Surgical Infection Prevention

  About three of every 100 operations performed in the United States are complicated by surgical site infections (Gaynes et al. 2001).
  Source: The Commonwealth Fund (December 2006)

• Centers for Medicare and Medicaid (CMS) web page on nonpayment of hospital-acquired infections and other conditions

  Includes the list of “hospital-acquired conditions” for which no additional payments will be made starting Oct. 1, 2009.

• Invasive Methicillin-Resistant Staphylococcus aureus Infections in the United States (PDF)

  Study reveals overwhelming majority of MRSA infections are acquired in hospitals and health care settings.
  Source: Journal of American Medical Association (October 17, 2007)

• Infections with MRSA in U.S. Hospitals, 1993-2005

  The Healthcare Cost and Utilization Project reports on the rise in antibiotic-resistant MRSA infection in hospitals.

• Report: MRSA infections are 8.6 times more prevalent than previous estimates

  The antibiotic-resistant bacteria is found in all wards throughout most hospitals. The study is the first nationwide analysis on the prevalence of MRSA in U.S. healthcare facilities.
  Source: (June 25, 2007)

• Dispelling the Myths: The True Cost of Health Care Associated Infections

  Report shows that hospital-acquired infections erode the profit margin of US hospitals by $5000 per infected patient.
  Source: APIC (February, 2007)

• Infections due to medical care in Oregon hospitals

  Report highlights the financial impact of hospital infections in Oregon
  Source: Office for Oregon Health Policy and Research (November 2006)

• Rates of C-Difficile infections reported in Ohio

  A new Ohio report shows that cases of C-Difficile infections exceed 1,000 every month.
  Source: Ohio Department of Health (March 2007)

• Institute of Progressive Medicine says hospitals should screen all patients for MRSA

  Institute criticizes statement by infection control groups opposing MRSA screening for all hospital patients.
  Source: (March 8, 2007)

• Invasive MRSA infections among dialysis patients

  A new report by the CDC underscores the need for better surveillance and infection-control strategies in dialysis centers.
  Source: (March 2007)

• Dispelling the Myth: The True Cost of Healthcare-Associated Infections

  Association for Professionals in Infection Control and Epidemiology (APIC) report highlights for hospital CEO's the financial impact of hospital-acquired infections.
  Source: APIC Briefing (February, 2007)

• Florida Gov. Crist calls for “best practices to reduce hospital-acquired infections and improve outcomes"

  See last paragraph
  Source: (January, 2007)

• Ohio publishes rate of c.difficile in state's hospitals

  Clostridium difficile is an increasingly important cause of infectious diseases, especially in health care settings. Find reported rates for Ohio acute care hospitals and nursing homes for 2006.

• Texas hospital infection committee recommends statewide reporting system

• Ventilator-Associated Pneumonia: Getting to zero

  Clinical evidence shows that hospitals can virtually eliminate such infections by following a special ventilator patient care protocol

• CDC guidelines on managing antibiotic-resistant infections in health care settings (PDF)

  New guidelines for U.S. health care facilities to control drug-resistant infections are strictly voluntary and fail to recommend proven prevention practices.
  Source: CDC

• Remaking American Medicine: First Do No Harm

  Beginning on October 5, PBS presents a four-part series on pioneering individuals struggling to fix our broken health care system. Episode Two, entitled "First Do No Harm," focuses on hospital infections and will air on October 12 on most PBS stations. Check local listings to confirm.
  Source: PBS-TV (October 12, 2006)

• Doctors told to stop shaving surgical sites to prevent infections

  Research has shown that skin abrasions caused by shaving increases the risk of postoperative infections.

• Congressional Hearing on Public Reporting of Hospital Infections

  Listen to a webcast of the House Oversight & Investigations Subcommittee's March 29, 2006 hearing on hospital infections by clicking on the link above.

• Institute for Healthcare Improvement touts lives saved by its hospital campaign

  Group says 60,500 lives have been saved in the first nine months of its one-year campaign to prevent unnecessary deaths at hospitals, including fatalities from infections.

• Institute for Healthcare Improvement challenges myth that infections cannot be eliminated

  The rate of ventilator associated pneumonia in 14 hospitals participating in IHI's 100,000 Lives campaign drops to zero.

• Pennsylvania releases new information about heart surgery and hospital infections

  Pennsylvania report identifies key findings about hospital-acquired infections in heart surgery patients.
  Source: Pennsylvania health Care Cost Containment Council (February 2006)

• Pennsylvania’s hospital acquired infection battle

  An in-depth look at how Pennsylvania is tackling hospital-acquired infections and getting significant results: saving lives, reducing illness, and lowering health care costs.
  Source: Physician's News Digest (February 2006)

• Active surveillance cultures helping to control infections

  The use of active surveillance cultures to screen patients for MRSA, along with appropriate precautions for infected patients is a promising new strategy for preventing and controlling hospital infectons.

• Guidance on public reporting of healthcare-associated infections

  Many state and national initiatives are underway to mandate or induce health care organizations to publicly disclose information regarding institutional and physician performance.
  Source: Centers for Disease Control and Prevention (January 2006)

• Prevent Antimicrobial Resistance in Healthcare Settings

  CDC: Of the estimated 1.6 million nursing home residents, 250,000 have infections, and 27,000 of them have antibiotic resistant infections.

• Ohio Health Committee Approves Hospital Infection Reporting Bill

  The Ohio House health Committee has approved legislation by Representative Jim Raussen that requires hospitals to report data on a whole range of health care quality measures, including hospital-acquired infections.
  Source: Ohio House of Representatives (December 14, 2005)

• Steps you can take to reduce the risk of hospital-acquired infections

  Most of us will have to go into the hospital some day. Here are specific steps you can follow to protect yourself from deadly hospital infections.

• Infection-Thwarting Catheters, Planning Key in Reducing Hospital Deaths

  New study shows that antiseptic-coated catheters and better safety measures in hospitals can significantly reduce the number of infection-related hospital deaths.

• MRSA Watch: Tracking the rise of antibodic resistant infections

  MRSA Watch site gives extensive information about studies, guidelines and recent stories about MRSA in the UK.

• Pennsylvania report based on 2004 data collected under that state’s law requiring hospitals to report hospital-acquired infections

  An astounding 76% of the infections were paid for by Medicare and Medicaid. Also, the report reminds us that the uninsured carry the heaviest financial burden, since they are unable to negotiate discounted prices with their hospitals, as do Medicare, Medicaid, and private insurance plans.
  Source: Pennsylvania Health Care Cost Containment Council (November 2005)

• The Institute for Healthcare Improvement has now signed up over 2900 US hospitals to participate in their 100,000 Lives campaign

  The Institute for Healthcare Improvement has now signed up over 2900 US hospitals to participate in their 100,000 Lives campaign. The purpose of the campaign is to save lives by using proven methods to prevent hospital-acquired infections and medical errors. Consumers should know about these life-saving practices and if your care in the hospital involves having surgery, IVs, or ventilators, be sure to ask if your caregivers are using them.

• Lack of Commitment to Cleaner Hospitals in the UK, Patients Association reports

  A report by The Patients Association into hospital acquired infections reveals haphazard approach towards screening patients for MRSA.

• A proactive approach to educate patients about and prevent hospital-acquired infections

  The Saskatoon Health Region in Canada has taken a proactive approach to educate their patients about and prevent hospital-acquired infections, including information about rates of infection. They have developed fact sheets for patients about common hospital infections – MRSA, VRE, and C. difficile – including how patients with these infections can minimize their spread and the prevention measures they should expect from hospital staff.

• Healthcare-Associated Infections (HAIs)

  CDC pages on healthcare-acquired infections and community-acquired infections

• The Problem of Antibiotic Resistance

  The problem of antibiotic resistance in treating hospital-acquired infections from the National of Allergy and Infectious Diseases discusses

• Hand Hygiene is the number 1 weapon against infections

  Reader Feedback: Hand Hygiene is No. 1 Weapon Against Infections

• National Hospital Compare site suspends effort to publicly report surgical infection prevention measure

  After careful consideration the CMS along with the JCAHO have agreed to temporarily suspend public reporting of hospital performance on appropriate antibiotic selection for surgical prophylaxis. CMS and JCAHO will continue to collect data on antibiotic selection for surgical prophylaxis during the temporary suspension but will not publicly report performance on this measure on Hospital Compare.

• Infection prevention experts stress importance of hand hygiene compliance

  Despite the fact that hand hygiene is the most simple and effective means of reducing the transmission of germs, many clinicians do not consistently follow hand hygiene recommendations, such as those issued by the CDC.

• Cost of hospital infections in New York

  An analysis by Assemblyman Pete Grannis estimates the state and local Medicaid cost of hospital infections is $100-$200 million each year.

• Patient Safety

  Minnesota releases adverse events report released. The report identifies 27 different “medical errors” (such as operating on the wrong part of the body or wrong patient) and “adverse events” (such as patient falls, suicide, and abduction), it does not include hospital-acquired infections. A new bill filed in the MN legislature (HF 87) will require inclusion of hospital infections in the future.
  Source: Minnesota Department of Health (January 20, 2005)

• Community-Associated MRSA - Frequently Asked Questions

  MRSA is a staph infection that is resistant to treatment by common antibiotics. Recently, “community acquired” MRSA (“CA-MRSA”) has been on the increase. The CDC has information available about MRSA.

• CDC's tips for surgery partients to prevent infections

  The Centers for Disease Control and Prevention (CDC) presents helpful tips on preventing hospital-acquired infections.

• The National Quality Forum Releases Voluntary Standards

  The NQF, a coalition of medical groups, employers, consumer groups and others, this year released practice standards to reduce hospital infection and other quality of care problems.

• JCAHO Asks Hospitals to Report

  Joint Commission on Accreditation of Healthcare Organizations this year asked hospitals to improve their reporting of hospital infections that result in serious harm or death to the patient (sentinel events).

• The Impact of Hospital Acquired Bloodstream Infections

  Researchers estimate that blood stream infections, a subset of all hospital-acquired infecation, may be the eighth leading cause of death in the U.S. Study sites other research showing substantial reduction in infection with better hand washing compliance.

• Hand Washing Prevents Hospital Infections

  The CDC estimates that each year nearly 2 million patients in the U.S. get an infection in hospitals, and about 90,000 of these patients die as a result of their infection. The CDC presents new hand-hygiene guidelines to reduce the spread of infections.

• Hospital Infections Cost U.S. Billions of Dollars Annually

  The CDC estimates that hospital-acquired infections cost us all nearly $5 billion a year.

• Illinois Passes State Law to Make Hospital Infection Rates Public

  A coalition of consumer, labor and employer groups supported the final passage of a groundbreaking disclosure law that makes infection rates public for Illinois consumers.

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