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State Board of Health

Board of Health Conference Call
January 19, 2005

Attendees: Dr. Deborah Jantsch, Dr. Donna Mannello, Dr. Thomas Macdonnell, Becky Buchholz, Ron Cates, Tricia Schlechte, Desiree Mowry

Guests: Garland Land, Eddie Hedrick, Irene Donelon

TOPIC DISCUSSION ACTION
SB 1279

Garland Land informed the board that due to the passing of SB 1279 during the 2004 legislative session, the Department of Health and Senior Services must see that Health Care associated infections are made public.

Missouri is a vanguard state in what will soon be a national trend to give the public access to information on infections obtained while in hospitals.

 

 The Department of Health and Senior Services drafted a rule regarding publishing data on nosocomial infections.
Nosocomial Rule

Three different types of nosocomial infections will be submitted to the DHSS.

  1. Central line-associated bloodstream infection (CLAB)
  2. Surgical site infection (SSI)
  3. Ventilator-associated pneumonia (VAP)

Hospitals will report CLAB and VAP that occur in the ICU based upon CDC (Center for Disease Control) standards.

The CDC has a standard of not reporting data if there is not a minimum number of cases.

Hospitals will report surgical site infection related to the following surgeries: hip prosthesis, Cesarean section, and coronary artery bypass.

Ambulatory Surgical Centers (ASC) will report surgical site infections by risk index related to breast surgery and herniorrhaphy.

 

 A letter is being sent to Missouri Hospitals to inform them that this rule is coming and encouraging participation with the National Healthcare Safety Network Surveillance System.
Data Becky Buchholz inquired about what will be done with the accumulated data.

The data compiled will go on the DHSS website benchmarked with other hospitals, in order for the public to see how the hospital is doing.

The data will be published by facility name.

This allows hospitals to see how they compare with other institutions and they can learn how to lower their number of nosocomial infections.

 
Cesarean Section Dr. Jantsch brought forth a concern in that a Cesarean Section is a Class II surgery and therefore more susceptible to additional infections than the other surgical site infections.

In SB 1279 192.667 Section 12, the law states that the surgery does not have to be a Class I surgery, but that other categories of infections may be established by rule by the DHSS. They chose Cesarean sections to get another sampling of patients and not only senior citizens.

Garland Land indicated that he had discussed the issue with the CDC and he felt that we would be able to use the same methodology as CDC is proposing to use for risk adjustment.

 
Clarification

Becky Buchholz wanted to clarify that only the infections that were obtained at the hospital and not pre-existing conditions would be reported.

 

 Garland confirmed this.
Motion to Vote to Publish Rule for Discussion

Becky Buchholz moved to approve Rule 19 CSR 10-33.050 Reporting of Healthcare-Associated Infection Rates by Hospitals and Ambulatory Surgical Centers. Dr. Donna Manello seconded the motion.

 

 The motion passed.