HHS funds $17M for fight against costly and dangerous health care-associated infections

Agency for Healthcare Research & QualityOct 24 2009

HHS Secretary Kathleen Sebelius today announced the award of $17 million to fund projects to fight costly and dangerous health care-associated infections, or HAIs.

"When patients go to the hospital, they expect to get better, not worse," Secretary Sebelius said. "Eliminating infections is critical to making care safer for patients and to improving the overall quality and safety of the health care system. We know that it can be done, and this new initiative will help us reach our goal."

HAIs are one of the most common complications of hospital care. Nearly 2 million patients develop HAIs, which contribute to 99,000 deaths each year and $28 billion to $33 billion in health care costs. HAIs are caused by different types of bacteria that infect patients being treated in a hospital or health care setting for other conditions. The most common HAI-causing bacteria is methicillin-resistant Staphylococcus aureus, or MRSA. The number of MRSA-associated hospital stays has more than tripled since 2000, reaching 368,600 in 2005, according to HHS' Agency for Healthcare Research and Quality's (AHRQ) Healthcare Cost and Utilization Project.

Of the $17 million, $8 million will fund a national expansion of the Keystone Project, which within 18 months successfully reduced the rate of central-line blood stream infections in more than 100 Michigan intensive care units and saved 1,500 lives and $200 million. The project was originally started by the Johns Hopkins University in Baltimore and the Michigan Health & Hospital Association to implement a comprehensive unit-based safety program. The program involves using a checklist of evidence-based safety practices; staff training and other tools for preventing infections that can be implemented in hospital units; standard and consistent measurement of infection rates; and tools to improve teamwork among doctors, nurses and hospital leaders.

Last year, AHRQ funded an expansion of this project to 10 states. With additional funding from AHRQ and a private foundation, the Keystone Project is now operating in all 50 states, Puerto Rico and the District of Columbia. The new funding announced today will expand the effort to more hospitals, extend it to other settings in addition to ICUs, and broaden the focus to address other types of infections. Specifically, the new $8 million in funding will provide:

• $6 million to the Health Research & Educational Trust for national efforts to expand the Comprehensive Unit-Based Patient Safety Program to Reduce Central Line-Associated Blood Stream Infections. The funding will allow more hospitals in all 50 states to participate in the program and expand the program's reach into hospital settings outside of the ICU. The Health Research & Educational Trust will also use $1 million to support a demonstration project that will help fight catheter-associated urinary tract infections.
• $1 million to Yale University to support a comprehensive plan to prevent bloodstream infections in hemodialysis patients.

AHRQ, in collaboration with the Centers for Disease Control and Prevention (CDC), also identified several high-priority areas to apply the remaining $9 million toward reducing MRSA and other types of HAIs. These projects will focus on:

• Reducing Clostridium difficile infections through a regional hospital collaborative.
• Reducing the overuse of antibiotics by primary care clinicians treating patients in ambulatory and long-term care settings.
• Evaluating two ways to eliminate MRSA in ICUs.
• Improving the measurement of the risk of infections after surgery.
• Identifying national-, regional- and state-level rates of HAIs that are acquired in the acute care setting.
• Reducing infections caused by Klebsiella pneumoniae Carbapenemase-producing organisms by applying recently developed recommendations from CDC's Healthcare Infection Control Practices Advisory Committee.
• Standardizing antibiotic use in long-term care settings (two projects).
• Implementing teamwork principles for frontline health care providers.

A complete list of institutions funded by the $17 million in resources awarded today is available at http://www.ahrq.gov/qual/haify09.htm.