But that kind of direct observation of the physical contact patients get can make a huge difference in infection rates.

Take the University of Maryland Medical Center in Baltimore. The hospital has a dedicated “germ cop” who observes all staff interaction with patients — from the chief of surgery to the janitors emptying garbage cans.

On a typical day, the infection control staff might remind a janitor to change gloves before moving a nurse’s cart in the hallway, advise a nurse to more closely shave the area around a patient’s catheter or point out to a doctor that he’s about to touch a patient without having washed his hands after examining the last one.

The process works: At UMMC, the surgical ICU has gone 24 weeks without a single case of infection, and hospital-wide, central line infections have been reduced by 70%.

Known as Healthy People 2020, the program is intended to set national goals for health and well-being. Based on input and feedback from public health experts as well as federal, state and local government agencies and the public, the agenda has included key areas, such as:

• Adolescent health
• Blood disorders and blood safety
• Dementias, including Alzheimer’s disease
• Early and middle childhood
• Genomics
• Global health
• Health-related quality of life and well-being
• Healthcare-associated infections
• Lesbian, gay, bisexual and transgender health
• Older adults
• Preparedness
• Sleep health, and
• Social determinants of health.

Learn more about the program here.

That’s the news from a study just published in Pediatrics.

Unlike other patient groups, kids were most likely to be hospitalized with infections that were community-acquired, not hospital-acquired. While that’s good news for hospitals’ infection control measures, it indicates that the bug’s antibiotic-resistance is on the rise.

The study also noted that use of clindamycin — one of the few antibiotics still effective against MRSA — had also risen dramatically as the number of MRSA patients increased. (Two other effective, but less convenient drugs, showed only modest increases in use.)

The study’s authors noted that increased use of just one drug, clindamycin, to combat MRSA could make it even more antibiotic-resistant. The researchers urged doctors to use clindamycin “judiciously.”

Abington Memorial Hospital, just outside of Philadelphia, began a multi-pronged program to virtually eliminate hospital-acquired infections. Among the steps taken: Using staff “spies” to make sure everyone involved in a patient’s care washed their hands both before entering the room and immediately after leaving it.

That’s the kind of labor-intensive program usually not undertaken unless a hospital is extraordinarily committed to fighting infection.

The hospital put together a team of staffers who tracked how many times other employees washed with soap and water or used the hand sanitizers stationed outside each room. For a staffer to get a “Yes” notation for proper handwashing they had to:

1. use the right form of handwashing (i.e. using soap and water, not hand sanitizer, after touching blood or feces), and
2. wash both on the way into the room and on the way out.

The first report showed a compliance rate of only 31%. The worst offenders? Physicians.

Selling the idea

To improve, the hospital took several steps, including putting up more sanitizer dispensers, putting handwashing “reminders” as the screensavers on all hospital computers and sharing the case of a previously healthy patient who had died from hospital-acquired MRSA.

The hospital also made it clear that patients, families and any employees — from physicians to janitors — should feel comfortable asking whether a staffer washed his or her  hands before touching a patient.

Less than two years later, a follow-up handwashing survey showed compliance at 88%. More importantly, rates of infections in patients are down significantly.

Researchers at the Mayo Clinic studied the effectiveness of daily cleaning high-touch surfaces in patient rooms with a bleach wipe. (The wipe contained 0.55 sodium hypochlorite.) The goal was to reduce the time between HAIs to more than 20 days among patients in two wards with high rates of C. difficile infection.

The results went far beyond that goal, with one of the two units studied going 137 days between infections.

Neither patients nor staff reported significant problems with the new cleaning regimen.

The results were presented at the 5th Decennial International Conference on Healthcare-Acquired Infections in Atlanta.

That’s the bottom line of a new report from the Healthcare Management Council (HMC). HMC analyzed federal data to identify the most common hospital-acquired conditions (HACs) as well as their annual cost per patient and the annual average cost to hospitals.

The results are startling. According to the report, HACs cost a 200-bed hospital roughly $2 million extra annually. Here are the results, broken down by most common type of complication:

1. Decubitus ulcers, more commonly known as bedsores, cost a mid-size facility roughly $536,000 per year, and $9,200 per patient.
2. Post-operative pulmonary embolisms (PE) and deep-vein thrombosis (DVT) cost hospitals $564,000 annually, at $15,500 per patient.
3. Accidental punctures and lacerations cost $248,100 per hospital — $8,300 per patient.
4. Post-operative respiratory failure cost $261,000 per hospital — $21,900 per patient.
5. Hospital-acquired infections cost an average hospital $252,000 — $24,500 per patient.

That’s the conclusion of a new study by the Robert Wood Johnson Foundation. The researchers studied 69 million discharge records from 2006 for hospitals in 40 states.

According to the study, patients who developed pneumonia stayed in the hospital an average of 14 extra days. Their increased treatment costs were approximately $46,000 per patient. Of those patients, 11% ultimately died from the infection.

Patients who acquired sepsis stayed in the hospital an extra 11 days, at a cost of an additional $33,000. The infection was fatal for 20% of patients.

The study was published in the Archives of Internal Medicine.

One company, Proventix, is testing a new type of badge to track hand-washing. Staffers such as nurses wear the badges which track when they enter patient rooms and whether or not they washed their hands upon entering or leaving.

The system is set up so that frequently non-compliant workers can get a text or e-mail reminding them to wash up.

Predictably, some workers dislike the idea of having their movements tracked so closely. And there’s still no data to show that such close monitoring actually changes how workers behave while on the clock.

What do you think: Is the privacy intrusion worth it to improve patient safety? Or is this a step too far? Sound off in the comments.

As more records go digital, hospitals and practices are better able to track everything from patient wait times to the rates and costs of hospital-acquired infections. But health care providers, who typically have little formal business training, don’t always have the tools to make the most effective use of all that data.

That’s why several universities and hospitals are now offering business courses — and even advanced degrees — for health care practitioners who want to learn a little more about the business side of the industry.

While it may not be immediately obvious how bean-counting can have a direct impact on patient care, the Wall Street Journal recently reported on a University of Pennsylvania program that aims to do just that.

The Penn Medicine Leadership Forum is a non-degree program run by the Wharton School of Business for employees of Penn’s medical branches. Doctors, nurses and providers who finished the program have gone on to begin programs to address issues such as surgical site infections. The programs are based on the teams’ analyses of existing patient data.

And because of improved data collection, clinicians will be able to see exactly how much of an impact these initiatives had — and how much time or money they save — instead of having to rely on a gut feeling that things are operating more efficiently.

A number of hospitals that have started programs specifically to combat and prevent the spread of infections have gotten significant results with little more than basic education and a re-emphasis on the importance of proper hygiene.

The most effective programs include required training sessions for staff, as well as increased vigilance about some of the basics, such as: proper hand washing, using antibacterials on patients before inserting IVs and ensuring that patients are properly draped before surgery and other procedures.

For example, Good Samaritan Medical Center, in Brockton, MA started an infection prevention program and saw an overall drop in hospital-acquired infections, including a remarkable 80% reduction in MRSA infections.

The programs have been most effective at reducing bloodstream and surgical site infections.