This Week's Headlines:

Are Staff Washing Their Hands? You Must Measure Compliance

Best practices will be identified

Lack of consensus on how to measure hand hygiene compliance has made this a daunting challenge for quality professionals. To address this, the Joint Commission has partnered with infection control organizations to identify how to measure compliance with hand hygiene guidelines. The final product of the 18-month project will be an educational monograph that recommends best practices for measuring hand hygiene compliance.

Effective measurement will help health care organizations target interventions, which in turn should improve hand hygiene practices by health care workers, and ultimately result in fewer health care-associated infections, says Jerod M. Loeb, PhD, executive vice president of the Joint Commission's division of research.

Measuring compliance with hand hygiene practices during the delivery of care is difficult, mainly because of the resources needed to monitor the practices of many different care providers in numerous locations for meaningful periods of time. Since there is no unified approach to measuring hand hygiene performance, it's impossible to determine whether overall performance is improving, deteriorating, or staying unchanged as new strategic interventions are introduced.

The Joint Commission's National Patient Safety Goals require accredited organizations to follow the Center for Disease Control & Prevention's hand hygiene guidelines, but many studies have shown poor compliance. In addition, the Joint Commission's infection control standards require continuous strategic surveillance for infection and infection-related risks, and this is a key focus during surveys.

[For more information, see the November 2006 issue of Hospital Peer Review newsletter.]

— Russ Underwood, editor

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MN First State To Offer Hospital Prices On-line

A new web site from the Minnesota Hospital Association (MHA) will enable consumers in the state to access price information on common procedures performed by hospitals in their communities.

Minnesota Hospital Price Check, which marks the first effort to share state hospital price information publicly, will offer data on the 50 most common inpatient stays (DRGs) and the 25 most common same-day procedures (CPTs).

A 2005 state law supported by the state's hospitals called for the release of data via a public web site by Oct. 1.

Prices listed on the site do not include charges by hospital physicians or specialists, who often bill hospital patients separately. MHA cautioned that the listed prices will frequently be different from a patient's out-of-pocket expenses, and urged patients to contact their insurance companies or their hospital's billing offices for an estimate of what they will pay.

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Supreme Court: Rules On EMRs Not Too Lax

The U.S. Supreme Court has rejected claims by privacy advocates that the Bush administration's rules pertaining to the development of an information system for electronic transfer of health data are too lax in protecting privacy. A suit filed by 10 groups representing 750,000 consumers, health care providers, and patients challenged a provision of a 2003 rule that says health care providers may decide whether to obtain patients' consent to use or disclose health information and that state may impose more stringent requirements. The suit sought to reverse a Court of Appeals ruling that said the government would be held blameless for any privacy violations. The government countered that the new rule did not displace or conflict with existing privacy protections.

President Bush campaigned on the issue of standardizing and computerizing medical records for all Americans within the next decade as a means of controlling cost and curbing documentation-based medical errors. Because all health care providers will need to have compatible technology and paper records and existing electronic records translated to a universal system, privacy and security of the records as they are converted has been a key issue for debate. Bush has said he is sensitive to privacy concerns and favors some level of consent before information is disclosed.

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Pneumococcal Vaccine Still Underused In Elderly

One third of target group unvaccinated

In 1998, an estimated 3,400 adults aged at least 65 years old died as a result of invasive pneumococcal disease. One of the Healthy People 2010 objectives is to achieve 90% coverage of non-institutionalized adults in this age group for both influenza and pneumococcal vaccinations. To assess progress toward this goal, the Centers for Disease Control and Prevention examined vaccination coverage for persons interviewed in the 2004 and 2005 Behavioral Risk Factor Surveillance System (BRFSS) surveys.¹

In 2004, the overall proportion of respondents in the target age group who reported ever having received pneumococcal vaccine was 63.4%. In 2005, the overall proportion of respondents age 65 or over reporting ever having received pneumococcal vaccine was 63.7%. On the basis of data from the National Health Interview Survey (NHIS), pneumococcal vaccination coverage increased by 32% (from 42.6% to 56.3%) among persons aged =65 years from 1997 to 2005, but coverage has remained nearly unchanged since 2002 (56.2%), the CDC reported.

"In the 2004 and 2005 BRFSS surveys, approximately 20% of persons aged =65 years who said they received influenza vaccine reported never having received a pneumococcal vaccination, indicating missed opportunities for pneumococcal vaccine administration at the time of influenza vaccination," the CDC emphasized. "Offering pneumococcal vaccine with influenza vaccination should facilitate improvement in pneumococcal vaccination coverage."

Reference

1. Centers for Disease Control and Prevention. Influenza and Pneumococcal Vaccination Coverage Among Persons Aged =65 Years — United States, 2004—2005. MMWR 2006; 55(39);1,065-1,068.

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