Consumers Union and the Washington State Hospital Association are still tangling over legislation approved unanimously by the Legislature to require more reporting by hospitals when patients come down with infections during care. The state Department of Health is taking the hospitals’ side, opposing requirements to do separate reports for every knee, hip or cardiac surgery.
Otherwise the parties agree on the bill, which is broadly meant to bring the state’s reporting requirements into alignment with the demands of Obamacare.
House Bill 1471 passed the House and Senate unanimously in the way Consumers Union prefers. But both approaches sought by CU and the hospitals expand reporting beyond current law to include central blood line infections acquired in virtually all areas of a facility. It also adds reports on whether hospitals are administering antibiotics before surgery, and it aligns the overall data collection with what other states must do under the Affordable Care Act.
Cassie Sauer of the hospital association has written a letter to Gov. Jay Inslee, asking him to veto language added to the original bill version, which had passed unanimously in the House . The amendment – which Consumers Union asked for and persuaded the Senate to add, and the House agreed to – ensures that infections occurring as a result of knee, hip and cardiac surgeries under current law will continue to be accounted for.
Under new federal guidelines, such reporting is not required.
In her letter, Sauer argues that retaining the reporting on specific surgeries would be a burden to hospitals. Unlike the new federal reporting requirements that require reports on total numbers of infections, the state reports have to be done on each surgical procedure – about 20,000 a year, each taking about 20 minutes to fill out – and that this is too time-consuming for the benefit gained, she says.
CU, which publishes Consumer Reports magazine, sharply disagrees and has been fighting all year to include more reporting than the first versions of the bill that passed the House unanimously in February.
“Hospitals are trying to eliminate this reporting requirement because they claim it is too much of a burden,” Lisa McGiffert, director of Consumers Union’s Safe Patient Project, who also wrote to Inslee urging him to sign the bill as amended. “But let’s not forget the burden for patients who end up with an infection who often have to endure more time in the hospital and additional surgeries and all too often die.”
In her letter to Inslee, McGiffert pointed out that the amended version of HB 1471 would let the reporting on heart, knee and hip surgeries to sunset after five years. She also noted that the amended bill passed unanimously in the House and Senate.
“The latest Washington (infections) report shows significant variation of annual infection rates among hospitals for hip and knee replacements, with rates ranging from zero to nearly one in 20 patients in larger hospitals and rates as high as 14 percent in smaller hospitals. Heart surgeries show similar variations among the few hospitals that perform them,” McGiffert wrote.
State Health Secretary John Wiesman also wrote to Inslee in favor of the veto, saying the additional state-specific reporting would not add much value. Wiesman’s letter says in part:
“Our goal is to replace outdated state specific surgical site infection reporting with nationally recommended measures suitable for public reporting. State specific reporting has minimal value for providers or the public due to the statistically insignificant number of these cases and the inability for providers or the state to follow national best practices. The reporting measures we are proposing add value to the public and advance patient safety. Hospital infection control is a dynamic and changing field and House Bill 1471 includes an efficient rule-making approach for the department to keep the state’s program on target and consistent with evolving federal reporting requirements.”
The original bill language was sponsored for DOH by Democratic Rep. Marcus Riccelli of Spokane in the House and by Democratic Sen. Nathan Schlicher of Gig Harbor in the Senate. Republican Sen. Randi Becker of Eatonville added the amendment sought by Consumers Union.
Inslee spokeswoman Jaime Smith said Friday the governor was still reviewing the bill and had not made a decision. He is scheduled to sign House Bill 1471 after 2 p.m. on Tuesday.