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KPBS Midday Edition

Report: Hospital-Acquired Infection Rates Improve In San Diego

The entrance to UC San Diego Medical Center in Hillcrest is shown in this photo taken in 2015.
Leo Castaneda / inewsource
The entrance to UC San Diego Medical Center in Hillcrest is shown in this photo taken in 2015.

Report: Hospital-Acquired Infection Rates Improve In San Diego
California Hospital Infection Report GUESTS:Lisa McGiffert, director, Consumers Union's Safe Patient Project Dr. Kim Delehanty, director, infection prevention, UC San Diego Health

Hospitals are places where people usually go to get well, but sometimes state hospital can make you sick. California tracks the number of healthcare associated infections that are transmitted each year. And will California hospitals are doing well compared with national baseline information, a number of large healthcare institutions report a significant number of infections acquired by patients in their care. Joining me is Lisa McGiffert she's director of Consumers Union's Safe Patient Project . Welcome to the program. Enqueue, good to be here. And Dr. Kim Delehanty administrator of the infection prevention of UC San Diego Health. Kim, welcome to the program. Thank you very much. Tell us more about the infection report, is a good use or bad use this year? Back well, it's a mixture of the news. This is where the hospitals have to report their infections to the state. They report on all whole array such as non-specific verse infections. There hospital specific so you can look up each hospital for the number of infections and how the incidence at that Hospital compare with the baseline set in the past.'s back so you can see improvement or known improvement. What we see in California overall is improvement. I would say we still have a long way to go, but we are seeing in most cases improvement rather than not. One area is Cetaphil except -- infections. That is very dangerous and on the CDC urgent watchlist. Hospitals are having trouble improving in the area. With her San Diego hospitals that improve their rates? Yes the reports singled out hospitals that improved from last year's report and also singled out those that did not. The improvements were Scripps green hospital, they did improve unseated the fill infections. The UC San Diego medical Center improved on one surgical procedure, abdominal surgeries. We also have Kim Delehanty from UC San Diego want to talk to us. Kim, do you monitor your own progress or lack of progress and how many healthcare associated infections there are in the hospital? Yes. We look at it in two ways one is outcomes which is your numbers or rates. Or now we have a unstandardized infection ratio which is a stratification so that you are comparing like hospitals to like hospitals because patient populations differ. These we follow monthly and or more frequently if there is concern or issue's. We compare ourselves not only to our internal benchmarks but local, national, and state benchmarks as well. The second piece is that we look at our processes and we measured those processes. These are steps we take to prevent infection such as hand hygiene compliance, use of personal protective equipment, bathing patients, that we we keep their biofilm down so that they are not all potential risk for maybe inoculating themselves with their own no moral floor of. Kim, is it so difficult to keep infection at a hospitals? I think the public thinks of hospital is almost sterile. Well, nobody is sterile. We're not sterile. The hospital environment is not sterile. What we're looking at is making sure that we prevent anything that the patient did not come into the facility with. For instance, the massive majority of infections that occur are from the patient's own flora. Our concern is to keep those germs from causing any infections regardless of where they originate from. For every cell that we have, there are 10 cells of fungi or bacteria that live on us. It is managing that and making sure we're not creating a situation. Lisa, are there San Diego hospitals on this most recent list that have reported high, what you might consider high infection rates for a year? Yes. The report points out certain hospitals that have high incidence of infections and have targeted them before for health -- help in the future. There are several hospitals on the C diff, there are three hospitals, Palomar, Sharp Memorial, and University of California San Diego that have shown that they have high rates of C diff infections. Two years in a row. What kind of help to these hospitals get? You say they are targeted for help. What do they get? As Kim discussed, they work internally and they know what they need to do to prevent infections. But the state this year says that they have worked with these hospitals and offered consultations and that probably involves having infection control professional go in from the outside and look in at the processes and give suggestions on how they might be able to improve. A little bit more targeted look at those specific areas where the hospital is falling behind. Cam, as laypeople we also hear that the overuse of antibiotics has something to do with the prevalence of hospital infections. You find that to be factual? A The overuse of antibiotics create numerous issues. There is potential increase for resistance. This makes it more difficult to treat if they are resistant. As this was talking about the seed of, this is an infection of normal gut flora, when we're looking at California, we are the highest state in the country that has CDI reported infections. There are a lot of things around why that is happening. HSN and the California public health does not stratify the transfer -- population. So if you have a transparent -- transplant population, they don't have any immune system, so the instance of CDI or C diff infection is higher in that population because they do not have an immune fish -- system to fight off infection. The other is identifying like hospitals to like hospitals, and those rates in numbers would seem different if we were doing that type of stratification. So UCSF, and UCSD which have bone marrow transplants inpatients and comparing those to one another as opposed to rural hospitals that old never see a transplant patient. The numbers can be confusing in that they clump everything to gather on the CDI. But we did get a consultation copy did come in and look at our process. We were 100% validated so we did not underreport or over report our infections. We're doing process improvement. And we are also looking at standardizing our testing because we know that about 20% of our CDI rate are false positives because of the testing we are doing right now which is a very sensitive and specific test. I am going to stop you because I am out of time. But if you would like to know if the people would let -- if the people listening would like to know how their hospitals studied, you can -- fared the study, you can see that at KPBS Midday Edition. I have been speaking with Lisa McGiffert director of Consumers Union's Safe Patient Project and Dr. Kim Delehanty director of infection prevention add UC San Diego Health. Thank you both very much.

Despite progress by California hospitals in lowering many types of healthcare-associated infections, MRSA, C-DIFF and others continue to be an urgent public-health problem.

The annual Hospital Infection Report, released this week by the California Department of Public Health, found that 392 acute-care hospitals reported 19,200 healthcare-associated infections in 2014. Another 34 hospitals showed significant progress in reducing infections from 2013 numbers, the report said.

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The study includes an interactive map of each hospital.

Lisa McGiffert, director of the Consumers Union's Safe Patient Project, said this year's report is mixed.

"What we're seeing in California overall is improvement," she said. "But we still have a ways to go."

She said the biggest area that needs improvement of clostridium difficile, or C-DIFF, infections.

Dr. Kim Delehanty, the director of infection prevention at UC San Diego Health, said UC San Diego hospitals keep track of their own infections, and work to prevent germs from spreading from a patient.

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UC San Diego Health reduced surgical-site infections from abdominal surgery from nine to two. Scripps Green Hospital in La Jolla nearly halved the number of C-DIFF infections from 47 to 28. Both these hospitals and several others in the San Diego area reported high infection rates in other areas.

McGiffert said that hospitals with significantly high rates will receive a letter of notification from California Public Health Outreach offering assistance, including staff tutorials.