MRSA

1
MRSA

• Illinois Hospital Association
• February 27, 2008

2
MRSA BACKGROUND

• Chicago Tribune Series on Infections
• Increasing Occurrences
• Consumer Organizations
• News Media
• National Studies
• Federal Hearings
• Medicare Payment Reduction for Hospital Acquired
  Infections Scheduled for FFY 2009 and Beyond

3
ENVIRONMENT

• International Concern
• Developments Started Overseas in Europe and U.K
• Most Publicly Fought Health Care Issue in
  England, Ireland, and Scotland
• Remember, Prime Minister Blairs 1 Domestic
  Re-Election Issue
• Public Reporting
• Hundreds of Lawsuits
• Media Blitz Everyday in England, Ireland, and
  Scotland
• Consumer and Patient Driven

4
England Papers
5
CLOSER TO HOME

• Canada Torontos Womens College Hospital
  (Formerly with Sunnybrook) 41 Bed NICU Shut Down
  from MRSA March 2007
• Toronto Lessons From SARS Revisited and Revisited
• Hospitals Required to Publicly Report Infections
  in 2008
• St. Pauls Hospital in Vancouver Undercover on
  Hospital Infections February 7, 2007

6
Closer to Home

• Indianapolis TV Expose Hidden Dangers of
  Hospitals February 2007
• Fort Wayne Dozens of Lawsuits
• Prison Lawsuits Across the Nation
• 14 States Facing Infection Legislation During
  this Spring
• Tallahassee Memorial HealthCare Hosts Press
  Conference on MRSA
• Media Coverage Continues Across Nation

7
Studies

• Over 200 Studies on MRSA Screening Effectiveness
• More Recent
• Illinois 54 Increase in Hospital MRSA Cases
  from Federal Fiscal Year 2003 To 2006
• CDC Study in Journal of American Medical
  Association (coincided with death of teenager
  from MRSA) Highlighting over 100,000 cases with
  over 19,000 Deaths In 2005 Based Upon CDC
  Surveillance Center Estimates
• Dr. Jarvis Point Prevalence Study With APIC
  Highlighting Over 1.2 Million Hospital MRSA
  Infections and 119,000 Deaths in 2006 and an
  Estimated 65,000 In Illinois Hospitals
• Several Other Recent Studies, including AHRQ,
  Showing a Dramatic and Steady Increase in MRSA
• More Clinical Studies Underway on Screening
  Effectiveness
• ICU and At Risk
• All Patients

8
Increased Surveillance of Hospitals

• Review and Enforcement of Medicare Conditions of
  Participation and COP Interpretive Guidelines
• Calls for Hospital Executive Leadership
• Performance Improvement on All MDROs
• Documentation of Infection Rates and
  Interventions
• Incorporation of CDC Guidelines As Appropriate
• Role of Hospital Leadership In Providing
  Resources To Address MDROs
• Required to Be Part of Annual Quality Assessment
  and Performance Improvement Project

9
LEGISLATION APPROVED AND SIGNED BY GOVERNOR

• SB 233 MRSA Screening Effective August 20,
  2007
• MRSA Screening in ICU and At Risk Patients As
  Identified By Hospital
• Enforcement of Hand Hygiene
• Proper Isolation Protocols
• Reporting of MRSA Hospital Acquired Conditions
  Using Present on Admission Coding

10
LEGISLATION APPROVED AND SIGNED BY GOVERNOR

• HB 192 MDRO Surveillance Effective August 20,
  2007
• Requirement to Implement Medicare Conditions of
  Participation
• Adherence to Hand Hygiene, Isolation Protocols
• Public Reporting of MRSA and C-Diff Rates by IDPH

11
Results

• Hospitals Screening
• Hospitals Publicly Talking in Media About
  Positive Effect of MRSA Screening Reducing
  Occurrences, Proper Treatment for Those Coming in
  With MRSA, and Reduction in Costs
• Public and Patient Awareness of MRSA and
  Treatments Increased
• 175 Illinois Hospitals Now Signed Up for IHI
  Initiative to Reduce MRSA

12
Challenges Remain

• Hand Hygiene Enforcement
• Growing Number of Community Acquired MRSA Cases
• Growing Number of Healthcare Acquired MRSA Cases
  in Other Settings
• Implementation of Isolation Protocols In All
  Healthcare Settings

13
Ongoing State Resources

• Legislation and Reporting Requirements
• http//www.ihatoday.org/issues/quality/statereq.ht
  ml
• Collaborative Intervention Efforts
• http//www.ihatoday.org/issues/quality/improvement
  .html
• State of Illinois Department of Public Health
• http//www.idph.state.il.us/health/infect/MRSA_hom
  e.htm