Hospital infection rates: Canary in the mineshaft

Five years after the Institute of Medicine issued To Err is Human, its devastating report on the toll of lives taken by medical errors, improvement is being made-but the pace is far too slow. Among indicators of how well, or poorly, hospitals do in protecting the safety of patients, one seems of unequalled potency: the hospital infection rate. That rate has risen by 20% in the past few years, according to a three-year study of 39 million Medicare hospitalizations performed by HealthGrades, and is the marker that correlates most highly with overall performance on a set of 13 patient safety indicators developed by the Agency for Healthcare Research and Quality (AHRQ). What can be concluded? The gap between hospitals that are good at protecting patients from error and those that are poor at it is getting wider.

The full text of the report, Healthgrades Patient Safety in American Hospitals, can be downloaded at http://www.healthgrades.com/ The report includes a listing of what the study finds to be the safest hospitals in the country.

But the news isn't thoroughly bad. According to Lucian Leape, MD, noted for his efforts to raise the consciousness of the health-care community about medical errors and their consequences, and who is quoted in the May 18, 2005, issue of JAMA, progress is being made-slowly.

Dr. Leape's coauthored article in JAMA (2005;293:2384) tabulates the clinical effectiveness of these and other safe practices.