Bid to cut hospital infections gains traction in Legislature

In the three years that state Rep. Tom Campbell has been crusading to stop hospital-acquired infections, one of the leading causes of death in America, the Pierce County Republican hasn't had to look far to point to a patient who might have been saved.

In 2002, Campbell's father died at a Seattle hospital where he contracted Clostridium difficile, the most common cause of diarrhea in hospital patients.

Campbell has made it clear he is not seeking retribution, only the prevention of needless deaths. But for years he has run smack into opposition from the state's powerful Hospital Association, which has argued that his bills to require hospitals to publicly report infection rates would give the public misleading information.

This year, Campbell has compromised. So have the hospitals. And his bill is finally getting traction. The bill passed a House committee 11-2 last month, and the full House was expected to vote on the proposal as early as Monday.

"This is the first step to fixing this deadly problem," said Campbell, of Roy. "The public has a right to know about the concern so they can protect themselves and their families."

Toll placed in thousands

The Centers for Disease Control and Prevention estimates that hospital infections kill 90,000 patients a year in the U.S.

Others cite even higher numbers: The Committee to Reduce Infection Deaths, a nonprofit advocacy group based in New York, claims hospital-acquired infections are the fourth-largest killer — taking as many lives as AIDS, breast cancer and auto accidents combined.

"Nobody knows how many are happening," says Lisa McGiffert, project manager for stophospitalinfections.org, a project of the Consumers Union.

"No one has ever reported this information to anyone."

That's true in Washington as well.

Campbell's bill, currently called Second Substitute House Bill 1106, would begin to change that by requiring hospitals beginning in July 2008 to report to the state rates of bloodstream infections in patients who are given a large intravenous hookup called a central line.

Over the next two years, other infections, including pneumonia associated with being hooked to a ventilator and infections at the sites of surgical incisions, would be added to the list of required reports. After that, the state Department of Health could add other infections associated with different procedures.

The measure is now a pared-down, step-by-step approach compared with Campbell's earlier attempts, which required reporting of a broad spectrum of infections.

The Washington State Hospital Association objected to having to report all types of infections, arguing that not all of them were acquired inside hospitals.

Cassie Sauer, spokeswoman for the Hospital Association, said such broad reporting would result in "incredibly misleading information."

For example, Sauer said, a large urban hospital might have a "fabulous infection-control program" but a high infection rate because it serves lots of homeless people or drug-addicted patients. And a hospital that cares for richer, healthier people might have a low infection rate despite a lousy infection-control program.

A more neutral stance

The Hospital Association is still not supporting Campbell's bill because of some of its technical provisions, but because of Campbell's compromises it is not actively opposing it, Sauer said.

There's also another factor: "We've had a shift in our membership," Sauer said. "They're not as resistant as before."

The infections listed in the new bill are "hospital-acquired and can be hospital-controlled," she said.

"If you're on a ventilator and you get pneumonia, it's definitely the hospital's fault."

Additionally, while reporting a single type of infection may not give consumers a full picture, Sauer said, such a report is "a great proxy for how invested the hospital is in controlling infections."

Over the past three years, as Campbell has fought to get his bill passed, 16 states have approved laws addressing hospital-associated infections.

In the meantime, Campbell declines to name the hospital where his father died — in part because he wants them all on the hook.

"I'd rather not make it personal," he says. "I just want to make the system improve. People are dying every day from preventable incidents."

Carol M. Ostrom: 206-464-2249 or costrom@seattletimes.com