Draft law designed to disclose hospital infections

The Consumers Union in Washington, DC, has drafted the following model legislation designed for patient safety advocates to introduce in individual states as the Hospital Infections Disclosure Act. Highlights of the draft are summarized as follows:

• Individual hospitals shall collect data on hospital-acquired infection rates for the specific clinical procedures determined by the department by regulation, including the following categories: Class I surgical site infection; ventilator-associated pneumonia; central line-related bloodstream infections; and urinary tract infections.
• Hospitals shall submit quarterly reports on their hospital-acquired infection rates to the designated state department. Quarterly reports shall be submitted, in a format set forth in regulations adopted by the state by April 30, July 31, Oct. 31, and Jan. 31 each year for the previous quarter. Data in quarterly reports must cover a period ending not earlier than one month prior to submission of the report.
• The director of the designated state department shall appoint an advisory committee, including representatives from public and private hospitals (including hospital infection control departments), direct care nursing staff, physicians, epidemiologists with expertise in hospital-acquired infections, academic researchers, consumer organizations, health insurers, health maintenance organizations, organized labor, and purchasers of health insurance, such as employers. The advisory committee shall have a majority of members representing interests other than hospitals.
• The advisory committee shall assist the department in the development of all aspects of the methodology for collecting, analyzing, and disclosing the information collected under the act, including collection methods, formatting, and methods and means for release and dissemination.
• In developing the methodology for collecting and analyzing the infection rate data, the department and advisory committee shall consider existing methodologies and systems for data collection, such as the Centers for Disease Control’s National Nosocomial Infection Surveillance Program. However, the department’s discretion to adopt a methodology shall not be limited or restricted to any existing methodology or system. The data
  collection and analysis methodology shall be disclosed to the public prior to any public disclosure of hospital-acquired infection rates.
• The department may, after consultation with the advisory committee, require hospitals to collect data on hospital-acquired infection rates in additional categories.
• The department shall annually submit to the legislature a report summarizing the hospital quarterly reports and shall publish the annual report on its web site. All reports issued by the department shall be severity adjusted. The annual report shall compare the severity-adjusted hospital-acquired infection rates for each individual hospital in the state. This comparison should be as easy to comprehend as possible. The report also shall include an executive summary, written in plain language, that shall include, but not be limited to, a discussion of findings, conclusions, and trends concerning the overall state of hospital-acquired infections in the state, including a comparison to prior years. The report may include policy recommendations, as appropriate.
• The state shall publicize the report and its availability as widely as practical to interested parties, including, but not limited to, hospitals, providers, media organizations, health insurers, health maintenance organizations, purchasers of health insurance, organized labor, consumer or patient advocacy groups, and individual consumers. The annual report shall be made available to any person upon request. No hospital report or department disclosure may contain information identifying a patient, employee, or licensed health care professional in connection with a specific infection incident.
• A determination that a hospital has violated the provisions of this act may result in termination of licensure or other sanctions relating to licensure or a civil penalty of up to $1,000 per day per violation for each day the hospital is in violation of the act.

(Editor’s note: For the complete text of the model legislation, go to www.stophospitalinfections.com.)