Health professionals spend many thousands of hours training to cure disease. But they can learn how to stop the spread of deadly hospital infections in just a few minutes, by learning five steps for putting lines (that is, tubes) into patients’ bodies.
Wash your hands. Clean the patient’s skin with chlorhexidine, a special antiseptic. Cover the patient fully in sterile drapes. Don full protective gear, including mask and gown. Add a sterile covering to the site afterwards.
In a now-famous study of Michigan hospitals, a physician named Peter Pronovost was able to reduce the rate of in-hospital infection nearly to zero, simply by creating a checklist with these steps and then having hospitals empower nurses to enforce it. The reduction took place in big hospitals and small ones, urban and rural, famous teaching institutions and obscure community establishments. In short, the strategy worked everywhere, which means it ought to work anywhere.
These sort of hospital infections kill as many as 20,000 people a year. And they cost a lot of money to treat. Each episode requires about $45,000 in overall spending, which adds up to more than $2 billion a year by some estimates. Getting doctors and hospitals to adopt the anti-infection strategy should be, as Atul Gawande has observed in the New Yorker, a “no-brainer.”
Listening to the health care debate, you might think that Congress agrees. The proponents of reform talk all the time about improving the quality of care, both to save lives and make it less expensive, and frequently cite hospital infections to make their point. (Even opponents of reform have been known to agree on this front.) And the bills they’ve moved through the legislative process supposedly follow through on this.
But if you look closely at the legislation, you’ll see that the proposals fall a bit short on that promise. The bill that passed the House of Representatives last month does have a section on reducing infections--and, smartly, it applies not only to hospitals but also to out-patient clinics, which are prone to the same problems. But the House bill requires only that hospitals and clinics report the incidence of disease. The bill doesn’t attach financial rewards or penalties to the results.
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COMMENTS (3)
I am for ideological purity when it comes to health care reform--and I don't mean just the abortion issue ideology of so called Christians who pick and choose which sin they will not insure. I represent a fledgling new and purer form of Christianity (7deadlysins.edu) that would not only resist any health care reform that included taxpayer funding of abortion, but any health care bill (reformed or current) that paid for or rewarded sin. In case the godless amongst us do not know the 7 deadly sins they are "wrath, greed, sloth, pride, lust, envy, and gluttony".
There are a multitude of behaviors covered in this listing and a multitude of health issues they cause that our group does not wan ... view full comment
I am for ideological purity when it comes to health care reform--and I don't mean just the abortion issue ideology of so called Christians who pick and choose which sin they will not insure. I represent a fledgling new and purer form of Christianity (7deadlysins.edu) that would not only resist any health care reform that included taxpayer funding of abortion, but any health care bill (reformed or current) that paid for or rewarded sin. In case the godless amongst us do not know the 7 deadly sins they are "wrath, greed, sloth, pride, lust, envy, and gluttony".
There are a multitude of behaviors covered in this listing and a multitude of health issues they cause that our group does not want covered. You sin, you pay. Gluttony is by far the most obvious. I propose that all diseases associated with gluttony (a sin that fair weather Christians ignore when they frequent buffet houses ) not be covered by health care reform. It might be easier to simply say that our group favors insurance for those rare cases of obesity that are not traceable to sin. You want an abortion you pay for it. If you want medicines for cholesterol or diabetes (especially type 2) or any other disease or sickness, acute or chronic, that is traceable to a sinful life style YOU pay for it. I suspect that most people make a virtue out of necessity so the sins we do commit fall off the radar. This blog is a wake up call to all of us who know the mind of God to attack Health Care insurance schemes that encourage or reward sinful behavior including our own. Our position on Abortion would be a lot more compelling if we also were willing to pay out of our own pocket for any and all diseases, sickness, or medical procedures that might be traceable to our sinful lives. Gluttony is a good place to start.
Sin comes with a price. Sins associated with sex abound. Abortion is just the tip of the iceberg. Syphilis and other STDs should not be covered. Any sexual act t (not biblically endorsed) with accompanying disease or illness, should be one that YOU pay for. Diseases or sickness, acute or chronic, that are the result of fornication, adultery, homosexuality (or heterosexuality when accompanied by lust in your heart) would be expressly not covered in any reform that our group endorsed. It should become clear that one of the practical advantages of this application of the “7 Deadly Sins” is that any health care package reform would become a lot more affordable. Our own research shows that more than 90% of current health care costs would become out of pocket expenses.
The Bible is clear as to how goes to heaven and who goes to hell. Now is a good time to get a head start.
Penalizing the lowest quartile is no answer, since no matter how effective procedures are, there is always a lowest quartile. However, it seems that hospitals, physicans, etc. should be required to treat all readmissions, diagonsis failures, etc. at their cost. Now that might create a interesting debate!
Penalizing the lowest quartile is no answer, since no matter how effective procedures are, there is always a lowest quartile. However, it seems that hospitals, physicans, etc. should be required to treat all readmissions, diagonsis failures, etc. at their cost. Now that might create a interesting debate!
Obviously, we don't have to get everything done at once. In fact, it would be prudent to get the more difficult aspects of reform out of the way first (affordable, universal coverage) and then focus on enforcing measures that would save taxpayers money.
Right now we're spending money. Lots of it. So it's just enough to get it through without your average American throwing a hissy fit. Later, when coverage is expanded, we can talk about taking measures to save taxpayers money and they'll sail through without opposition.
Perfect? No. But practical? Yes. Of course, it's up to those best informed about these issues to keep the pressure on our elected officials until something is done. But ... view full comment
Obviously, we don't have to get everything done at once. In fact, it would be prudent to get the more difficult aspects of reform out of the way first (affordable, universal coverage) and then focus on enforcing measures that would save taxpayers money.
Right now we're spending money. Lots of it. So it's just enough to get it through without your average American throwing a hissy fit. Later, when coverage is expanded, we can talk about taking measures to save taxpayers money and they'll sail through without opposition.
Perfect? No. But practical? Yes. Of course, it's up to those best informed about these issues to keep the pressure on our elected officials until something is done. But we don't need to do it now.