Herd Immunity: Consumers Union Joins Effort to Map Healthcare Infections

The good people at Consumers Union's Safe Patient Project are helping Antidote put healthcare-associated infections on the map.

Taking up my challenge laid down earlier this month, Daniela Nuñez and Lisa McGiffert provided a long list of media coverage they had captured of outbreaks and infections at hospitals, clinics and other healthcare facilities in recent years. What is interesting about this list is not just the infections themselves, but the difficulty that some media outlets had in finding out about them, underscoring the need for a map.

Take The Arizona Republic. In May 2010, Ginger Rough wrote about an outbreak of Clostridium difficile in Phoenix-area hospitals.

Rough did not receive a press release from a state or county agency about the outbreak. She did not receive a notice from one of the hospitals themselves. She found out that a "health alert" had been issued by the Arizona Department of Health Services, but the alert only went to healthcare facilities. The public had been left in the dark. So she filed a state Public Records Law request to get access to the alert itself. The state gave her next to nothing. Rough wrote:

The alert contained no information about how the outbreak started, which hospitals were involved or how many patients were affected. County officials maintained that they were not obligated to provide that information.

So Rough pushed. It seems hard to believe that a reporter would have to work this hard to find out about a life-threatening infection, ostensibly being tracked by public health agencies funded by taxpayer dollars. But Rough did have to work that hard and ended up with a meeting.

This week, officials with the county Public Health Department and Banner Health, a non-profit group, met with a reporter and an editor from The Republic. Banner revealed that Banner Baywood Medical Center in Mesa had identified the strain after seeing some patients become very ill. The hospital alerted the county to the problem in early March. ‘If there's a cluster, an outbreak, we want to report that,' said Dr. John Hensing, executive vice president and chief medical officer at Banner Health, a Phoenix-based non-profit health-care group.

To whom?

Apparently only to the county, which then sends a note to the state that sits in a file somewhere. As Rough wrote:

Arizona, like many other states, does not track incidences of C. diff. But a Republic analysis of hospital-discharge records shows that from Jan. 1, 2008, to Dec. 31, 2009, patients at Arizona hospitals were identified as having a C. diff infections more than 15,400 times.

Many of those patients could have arrived at the hospital with those infections, and, perhaps not surprisingly, Banner Health officials "say they believe that most, if not all, patients came to Banner Baywood with an active C. diff infection, rather than contracting it at the facility. Some arrived from long-term-care facilities and nursing homes or went to the emergency room after falling sick at home."

Banner Health also said:

The patients were elderly, suffered from other health problems and had been on extensive antibiotics. Prolonged antibiotic use can heighten a patient's susceptibility to C. diff because the drugs can kill off the body's "good" bacteria, allowing it to flourish.

Where, exactly, did the patients receive the antibiotics? At the supermarket?

This is exactly why healthcare-associated infections should be covered better by the media. The reason Banner Health was so squeamish about revealing which hospital had an outbreak is because it did not want to cause a panic that sent patients fleeing from the hospital. Completely understandable.

But the situation the Banner Health official describes is the heart of the problem. Antibiotics, administered by health professionals, may have created the conditions that gave rise to an infection outbreak in a health facility. The effort to save one life may be a threat to another life – or many other lives.

That deserves more discussion and scrutiny, not ducking and dodging.

Send your examples to askantidote@gmail.com or via Twitter @wheisel. I'll map them.