With proponents of the Affordable Care Act hoping the new law will shift the focus of American health care from cost to quality, the Senate Committee on Health, Education, Labor and Pensions held a hearing on Tuesday that addressed an issue of quality that puts a costly burden, in expenses and lives, on the U.S. health care system.
Health-care associated infections, or ailments patients acquire during and after treatment, affect about 1 in 20 hospital patients at any given time, according to the Centers for Disease Control and Prevention. That amounts to approximately 1.7 million infections and 90,000 deaths every year, at the steep cost of about $30 billion.
“This is one of the thorniest health care quality challenges of our time, but we are making significant progress,” Senator Tom Harkin, chair of the HELP committee said during his opening statement. “The most important lesson of today’s hearing is that these mistakes and tragedies are avoidable.”
At Tuesday’s hearing, members of the health community and advocates for patient safety testified before the committee to detail efforts occurring within the health care system that can significantly reduce health care associated infections.
Infections can be particularly deadly if they lead to a condition called sepsis, during which the immune system responds overwhelmingly to an infection, triggering inflammation and often leading to multiple organ failure as the body goes into shock.
Sepsis kills over 200,000 Americans every year, more than AIDS, prostate cancer, and breast cancer combined
Renita Kilby, 50, who sat in the audience during Tuesday’s hearing, barely survived her bout with sepsis, which she developed after an infection during a routine hysterectomy.
Kilby spent three weeks in a coma, and later underwent four surgeries, lost hearing in her right ear, and racked up over $300,000 worth of medical bills.
“In my opinion it’s a senseless thing to have to happen to someone because it can be preventable,” Kilby says. She also depends on a wheelchair because her infection caused intense damage to her spine.
All infections, experts noted, are extremely preventable and can be reduced through acts as basic as washing hands between patients.
“Hand washing is probably the single most important thing that anyone can do to prevent transmission of infections,” Beth Bell, the director of the national center for emerging and zoonotic infectious diseases at the CDC, said during the hearing.
In fact, a trial conducted across 74 intensive care units involving over 74,000 patients found that using antimicrobial soap and applying nasal ointment at the time of admission for all ICU patients led to a 44% reduction in central-line bloodstream infections. Over the past four years, incidences of surgical-site infections have decreased by 20% and Methicillin-resistant Staphylococcus aureus, or MRSA, infections in hospitals experienced a 54% decline.
Beyond hand sanitation, the federal government and private and local partners are working together to continue reducing and preventing infections that occur during treatment.
The CDC tracks infections and provides health care facilities and communities across the nation with data to identify issues and measure progress through the National Healthcare Safety Network (NHSN), the largest monitoring system for healthcare associated infections.
Patrick Conway, the acting director of the center for Medicare and Medicaid innovation, testified that the Centers for Medicare and Medicaid Services no longer pays hospitals for additional costs associated with what they consider “hospital acquired conditions” or HACs, which include some surgical site infections and urinary-tract infections that are not present upon admission.
Pay incentives such as this, Conway said, will help improve the quality of health care for patients inside and outside of the Medicare system. This system is similar to the Medicare readmissions program under the Affordable Care Act, which reduces payments to hospitals with excessive readmission rates.
Panelists also emphasized the importance of private-public partnerships, much like the Patient Safety Movement is a coalition of care-providers, patient advocates and medical technology companies that have joined together to eliminate preventable deaths completely by 2020.
For Ciaran Staunton, however, Tuesday’s hearing had a more special meaning. His testimony before the committee represented the first time the infection that killed his 12-year-old son Rory, was being addressed publically before the full committee.
On April 1, 2012, Rory died of multiple organ failure caused by septic shock. Before Rory’s death, the Staunton family, like many Americans, had never heard of sepsis. After, however, the Staunton’s became advocates for awareness in their home state of New York, and pushed New York Gov. Andrew Cuomo to adopted regulations for detecting the condition, in honor of Rory.
During his testimony, Staunton called on Congress to increase awareness of sepsis through nation-wide sepsis education initiative, much like what “Rory’s Regulations” do in New York.
“Had we heard of sepsis, we’d have checked for sepsis,” Staunton told TIME. “Information and awareness costs nothing, but it may well save lives.”