ST. PAUL — Minnesota consumers can already find out how much hospitals charge for common procedures and how often the care centers commit serious errors called “never events,” such as operations on the wrong body parts.

In the latest step in the transparency movement, hospitals will soon have to report publicly on patient infections that directly result from surgeries or other hospital care. The new requirement, approved last month by the Legislature, takes effect in 2009.
Supporters hope it will give patients meaningful information for choosing hospitals and also pressure hospitals to adopt the “best practices” for infection control.

“It puts some accountability on us to make sure we are doing that,” said Dr. Boyd Wilson, infection control director for the HealthEast system.

Infections can occur among surgery patients, pneumonia patients with breathing tubes and patients with catheters or central lines inserted into their bloodstreams.

“It is a fundamental measure of patient safety, and I think the patients understand it, and they can relate to it,” said Lisa McGiffert of Consumers Union. “They can see a lot of dirt and filth, they can see people not washing their hands. It’s very visible.”

The Consumers Union has urged state legislatures to require public reporting on infections. More than 15 states have such laws on the books.

Minnesota hospitals will be required to follow guidelines from the National Quality Forum that won’t be released until this summer.

One big question is whether hospitals will report “outcome” measures, such as the rate of infection among patients, or whether they will report “process” measures, such as the frequency with which hospitals use proven prevention measures.

Some hospital officials worry that reporting actual infection rates could give a false picture of cleanliness, especially among facilities that treat sicker patients who are more prone to infections.

“Process measures are easier to do and to understand,” HealthEast’s Wilson said. “Either you’re doing what is expected to be the best practice or you’re not.”

For instance, one process measure is the percentage of patients who receive antibiotics within one hour of surgeries, which minimizes the chance of infections.

In Pennsylvania, officials published comparable infection rates for hospitals.

Joe Martin, a spokesman for the state’s Health Care Cost Containment Council, downplayed concerns about the comparisons, noting that infections often are traced back to poor medical practices, not the severity of patient conditions.

“We think this is basically a pretty simple consumer issue,” Martin said. “You didn’t have an infection when you came in the hospital, and you developed one after you were admitted. That’s a hospital-acquired infection.”

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