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Statement of Senator Tom Harkin (D-IA) At the HELP Committee Hearing: “U.S. Efforts to Reduce Healthcare-Associated Infections”

*As Prepared for Delivery*

“In the late 1970s, a group of researchers began to examine reports of patient deaths and injuries caused by anesthesia.  They found wide variation in quality, and a disturbing incidence of medical errors, leading to 6,000 deaths or serious injuries annually.  ABC’s “20/20” news program covered the study, and the modern patient safety movement was born.

“We are meeting today because, more than 30 years later, safety and quality in health care facilities remains a pressing concern.  Specifically, we’re here to discuss a problem that has bedeviled health care for decades – infections acquired while a patient is being treated.  Every year, about 1.7 million people in the U.S. get these healthcare-acquired infections.  They impose tremendous costs – in dollars, but most tragically, in human suffering.  The CDC estimates that these infections cause 270 deaths every day, and a recent study shows that the five most common hospital-acquired infections cost the system $10 billion each year.  If you include all infections acquired in all settings, the cost is between $30 and $45 billion annually.  That’s money that could be spent on improving quality, reducing the cost of care, or any number of other investments.

“Just as dangerous as an infection picked up in the hospital is the failure to properly detect and treat an infection.  One of our witnesses, Ciaran Staunton, will tell a tragic story about his son that illustrates how the failure to detect can be a fatal problem.  I’ll let Mr. Staunton tell his story, but let me just say that his son died of an infection that was detectable and survivable. 

“An Iowan wrote me last week with a similar story. Last year, Vanessa’s father—Wes Shubert, from Clear Lake—got a cut on his right wrist.  ‘His doctor failed to prescribe any antibiotics. Needless to say it was downhill from that point. They did an emergency surgery to remove the infection from his knee, then sent him home; even though I pled with the medical staff to please observe dad overnight because something was not right.’ Less than 24 hours later, Vanessa’s father was back in the emergency room, and tragically he died shortly afterward.

“This is one of the thorniest health care quality challenges of our time – but we are making significant progress.  Federal and state governments are making significant investments in quality improvement, investments that Dr. Bell and Dr. Conway will talk about in detail.  For the first time, public officials, providers, payors, and other stakeholders have the tools to reward high-quality—not high-volume—care.  And, perhaps most importantly, we’re stopping payment for bad care.

“Our witnesses will discuss these initiatives in depth, but let me just touch on one of them—the Partnership for Patients, started in spring 2011, is a public-private partnership with over 3,700 participating hospitals.  The goals of the initiative are bold – to reduce preventable hospital-acquired conditions by the end of this year by 40 percent, compared to 2010 levels; and to reduce all hospital readmissions by 20%, saving more than 60,00 lives, and preventing 1.8 million needless injuries.

“And this work is paying off.  As Dr. Conway will describe, the hospital readmission rate is declining over the last two years – translating to thousands of seniors staying home and healthy.

“In the private sector, conscientious providers, researchers, and academics have made great strides in improving quality of care.  Our second panel will discuss some of these innovative approaches.

“In my colleague’s state of Connecticut, the Public Health Department was recognized last year with a Future of Public Health Award for its work in reducing healthcare associated infections in nursing homes.  And in another colleague’s state, Rhode Island Hospital has reduced the incidence of a particularly deadly infection by 70 percent, saving lives and dollars.  Officials said that hospital-wide participation and cooperation was essential to this success.

“We need such bold action, with everyone pulling in the same direction.  A study in the journal Health Affairs found that, on average, a third of patients admitted to a hospital suffer a medical error or other adverse event—ten times greater than previously thought.  The most important lesson of today’s hearing is that these mistakes and tragedies are avoidable.  With hard work, innovation, and investment, we can win this fight.”