Even as it reports progress on efforts to eliminate healthcare acquired infections, known as HAIs, the Department of Health and Human Services is calling for comment on an updated plan to strengthen its work. The initiative, which calls for the use of health information technology to detect and monitor infections and to aid in reporting, could save tens of thousands of lives billions of dollars each year, according to HHS.

The news is not all good. The rates of one type of infection remain at historic highs. Clostridium difficile (C. difficile) is a germ that causes serious diarrhea, kills 14,000 Americans each year and adds an estimated $1 billion in extra costs to the healthcare system. While many HAIs declined in the 2000s, data from the Agency for Healthcare Research and Quality show that the number of hospital stays associated with C. difficile tripled before leveling off at historic high rates.  In addition, a recent CDC report showed that C. difficile infections have moved beyond hospitals and that 75 percent of these infections now begin in medical settings outside hospitals, such as nursing homes and outpatient clinics.

The updated National Action Plan is posted on the HHS site and an announcement of the request for public comments on the National Action Plan will be published in the Federal Register the week of April 23. The HHS Office of Healthcare Quality (OHQ) is soliciting public comments on the revised action plan through June 22, 2012.

“Today, we celebrate the rapid progress achieved through concerted efforts to reduce preventable infections in hospitals,” said Howard Koh, assistant secretary for health. “Already we are saving lives and reducing unnecessary healthcare expenditures. Through dedicated and conscientious partnerships, we are well-positioned to make hospitals safer and extend the same gains to all places of care.”

A new state-by-state breakdown by the Centers for Disease Control and Prevention (CDC) demonstrates that HAIs in hospitals have been declining since HHS first introduced its National Action Plan to Prevent Healthcare-Associated Infections: Roadmap to Elimination in 2009. The CDC report also pinpoints specific medical procedures that require stronger infection prevention efforts to maximize patient safety.

According to data submitted to CDC’s National Healthcare Safety Network and reported in the HAI Action Plan, central line-associated bloodstream infections have declined by 33 percent, surgical site infections (SSIs) have declined by 10 percent, and catheter-associated urinary tract infections have declined by 7 percent since the baselines were set.

In addition, invasive Methicillin-resistant Staphylococcus aureus (MRSA) infections have declined by 18 percent, and the use of measures known to prevent SSIs, as reported by the Centers for Medicare & Medicaid Services' Surgical Care Improvement Project, have steadily increased since the baseline was established.  These reductions are in line with the prevention targets detailed in the HAI Action Plan and the HHS Partnership for Patients initiative.

The HAI Action Plan has nine goals:

• 50 percent reduction in bloodstream infections
• 100 percent adherence to central line insertion practices
• 30 percent reduction in Clostridium difficile infections
• 30 percent reduction in Clostridium difficile hospitalizations
• 25 percent reduction in urinary tract infections
• 50 percent reduction in MRSA invasive infections (in the general population)
• 25 percent reduction in MRSA bacteremia
• 25 percent reduction in surgical site infections
• 95 percent adherence to surgical SCIP measures.

Since 2009, the HAI Action Plan has marshaled resources across HHS, several other federal agencies, and numerous stakeholders in a concerted effort to substantially reduce HAIs by 2013.  Phase 1 of the effort focuses on combating HAIs in hospitals, while Phase 2 focuses on ambulatory surgical settings, end-stage renal disease facilities, and the influenza vaccination of healthcare personnel. A new third phase, to initiate next summer, will focus on long-term care facilities.
 
The HHS Partnership for Patients works to accelerate progress against HAIs through highly structured learning collaboratives to support hospitals nationwide in adopting and helping to spread proven interventions so that they become the standard of care. The Partnership for Patients is a nationwide public-private collaboration focused on keeping patients from getting injured or sicker in the hospital, and helping patients heal without complication once they are discharged. 

Other Partnerships for Patients partners, including state and national associations, consumer groups, unions, employers, researchers, community-based organizations, patients and others also are collaborating to help to accelerate progress against HAIs and other preventable conditions. HHS welcomes additional partners in these efforts to build the healthcare system that Americans need, desire and deserve.