Gov. Jay Inslee rejected pressure from the Washington State Hospital Association and signed a bill into law Tuesday that requires much broader reporting of patient infections that happen during care in hospitals.
House Bill 1471 aligns the state’s reporting with Obamacare by requiring public reports on a broad array of bloodstream infections occurring virtually anywhere in a hospital. As signed by Inslee, the measure also retains three key reporting provisions of the state’s landmark 2007 infections-reporting law that deal with cardiac, knee or hip surgeries.
Consumers Union had pushed to retain the three surgeries, but the hospitals group said this would lay an excessive burden on facilities and it had asked Inslee to veto those three elements from the bill. But Inslee signed the measure – vetoing only a section containing an error that inadvertently would have made the entire law void after 2017.
Inslee later said during a question-answer time with reporters that the bill does require record keeping for hospitals but that this already is being done for knee, hip and heart surgeries and the continued reporting will give a better idea whether the information is useful.
“There is a sunset provision in the bill. We’ll be able to review in a few years the efficacy of this reporting requirement. And these infections can be so catastrophic that I think it warranted this effort to reduce infections …,” Inslee explained. “[W]hat we have found is there can be very profound improvement of infection rates once we focus hospitals on trying to make those improvements. So I thought it was the right move. “
Lisa McGiffert, director of Consumers Union’s Safe Patient Project, said in an email the decision is good for consumers. “Governor Inslee deserves credit for standing up to the hospital association and siding with consumers. This bill will promote greater transparency and help hold hospitals accountable for protecting patients from dangerous and sometimes deadly infections.”
Under terms of the bill, reporting will be expanded to virtually all areas of a hospital for a wide array of what are called central line bloodstream infections – as well as infections related to abdominal hysterectomies and colon surgeries. The law also requires reporting on whether hospitals are administering antibiotics before surgery.
Cassie Sauer of the association has said that hospitals must spend 20 minutes per surgery compiling the reports on heart, knee and hip surgeries whether an infection takes place or not. That is far more time consuming than the bulk reporting under the rest of the bill, according to the association. In a statement after the bill-signing, Sauer said:
Hospitals are dedicated to reducing infections and will work with the state to implement the law. Consumers and providers will have more information about infections from central lines, which are tubes placed in patients used to give fluids, blood products, chemotherapy and other drugs directly into the bloodstream. Consumers and providers will also be able to see how hospitals compare on infections resulting from colon surgery, which can be difficult to revent.
Hospitals will be able to compare infection rates in those new areas with other hospitals across the country. In four years, the federal and state infection reporting will be in sync, which will allow for meaningful comparisons and streamlined reporting processes.
Consumers Union has argued that despite low infection rates the reporting is valuable for cardiac, knee and hip surgeries. In a news release, it said: “The latest Washington 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.”
Democratic Rep. Marcus Riccelli of Spokane sponsored the original bill at the request of the Department of Health, which also asked Inslee to veto reporting on hip, knee and cardiac surgeries. The language of that original bill came out of a work group, and Riccelli said that Consumers Union did not register its complaints until the measure was already getting voted out of committee.
After Consumers Union objected to the bill that passed unanimously in the House,
Republican Sen. Randi Becker of Eatonville introduced language to add the three surgeries until 2017. Democratic Sen. Nathan Schlicher, who sponsored a Senate version of the bill, agreed with the changes – with a sunset of the reporting in 2017.
“In the end this moves us toward aligning with federal standards,” Riccelli said. “Improving reporting requirements is going to have better outcomes for patients and the
Riccelli said that his own father had received a stubborn MRSA, or methicillin-resistant staphylococcus aureus, infection during a knee surgery in a hospital.
Sen. Karen Keiser, a Des Moines Democrat and leader on healthcare in the Legislature, said she thinks the bill is now in a good form and she does not believe reporting requirements for hospitals will be too onerous.