Six years after a landmark state law forced Washington hospitals to publicly report the rates at which their patients were catching serious infections while in care, Washington lawmakers are tinkering with the law. And that worries a major consumer advocacy group, Consumers Union.
The proposals, which are meant to align state law with federal rules under Obamacare, also stop the reporting for infections caused during cardiac surgery or hip and knee replacements.
Consumers Union, the public-interest group that publishes Consumer Reports magazine, is blowing a whistle, arguing that changes to the hard-fought 2007 law it championed would limit information that consumers need and want.
The original law in 2007 was authored by a former state representative, Tom Campbell, a Republican from Roy. It immediately put Washington in the forefront of states along with Pennsylvania and New York.
“The issue for us is diminishing reporting. (Washington) state led the way, and if the states had not led the way, we would not be where we are with the federal government,” said Lisa McGiffert, who leads CU’s national Safe Patient Project and has advocated for disclosure laws adopted by 30 states and the District of Columbia.
But the health care committees in both the state House and Senate have unanimously approved the reform bills, and House Bill 1471 and Senate Bill 5415 both are waiting for floor votes in each chamber.
Top lawmakers advancing the bills this year disagree that the 2013 proposals cut corners.
“We supported it because it actually ends up aligning with what is being reported to the feds. That reporting wasn’t in place when we originally passed our bill,” wrote Rep. Eileen Cody, a Seattle Democrat, nurse and chairwoman of the House Health Care & Wellness Committee.
Cody, Senate health committee chairwoman Sen. Randi Becker and Sen. Karen Keiser, the ranking Senate Democrat on health care, all say they are trying to streamline the data reporting and to align state and federal requirements so that scarce medical dollars are used where they do the most good.
Keiser, of Des Moines, argued for the Senate bill, which was sponsored by Democratic Sen. Nathan Schlicher, an emergency-room doctor from Gig Harbor.
“Simplifying state law to align with federal law is more efficient. The new federal infection standards include 14 hospital-acquired conditions and 11 different sites of surgeries and procedures, and in my view remains a representative sample of high risk areas,” Keiser said in an email.
“While it reduces reporting on heart surgery, it adds reports on colon and abdominal hysterectomy procedures,” Keiser said.
Each bill also adds new reporting requirements for bloodstream infections and use of antibiotics before surgery, and each expands the reporting to infections acquired in more areas of a hospital.
“I know that Consumers Union is now weighing in, but I think that it is probably as important to know if hospitals are administering antibiotics prior to surgery rather than their infection rate,” Cody said in an email. “You know I would rather prevent a problem than count the problems that happen.”
CU’s McGiffert said that keeping Washington’s standards higher than federal standards is a good thing for patients — especially for those seeking elective knee or hip surgeries that are expected to become far more common in the next decade.
Despite voting for the original bill, Becker said Friday that she is developing an amendment that would require that three of the omitted procedures be covered, making state law more stringent than federal requirements.
“Hips, knees and cardiac were my concerns. … So we’ll be in excess of federal rules, but I’m OK with that,’’ said Becker, R-Eatonville.
The Washington State Hospital Association backs the original bills, and spokeswoman Beth Zborowski said hospitals would oppose Becker’s amendment. That is because they have finite resources and want to do the monitoring and reporting where it is shown to do the most good, Zborowski said. She said infection rates are lower and less serious for the reporting that would be cut.
Hospitals initially resisted the 2007 legislation, but Zborowski said they now embrace the disclosure culture that is leading to improvements in patient safety.
A state legislative analysis cites data from the federal Centers for Disease Control and Prevention that show patients have 1.7 million hospital-acquired infections yearly in the United States, affecting 5 percent of patients admitted to hospitals. The analysis says this adds $26 billion to $33 billion in costs nationally and contributes to 99,000 deaths each year.
INFECTION DATA
The Washington State Hospital Association reports on hospital safety and infections at its website, wahospitalquality.org.
Brad Shannon: 360-753-1688 bshannon@theolympian.com
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