As health care budgets are cut across the country, more accountability is expected from all of us to reduce unnecessary costs to health care systems and more importantly, to reduce unnecessary illnesses and deaths from easily preventable illnesses. Let’s start in our hospitals.
Forty million operations are performed in U.S. hospitals each year, and between 800,000 and 2 million individuals (approx. 1 out of every 24 surgical patients) contract surgical site infections (SSIs) annually, increasing their likelihood of death by up to 11 times and increasing the cost of health care by millions of dollars a year. Yet many SSIs can easily be prevented.
Who would guess that health care–associated infections are a major cause of death in the United States, more than breast cancer, HIV/AIDS and drunk driving combined?
If we want health care reform, let’s try to reform “best practices” in hospitals nationwide, beginning with SSIs.
Studies have shown that significant improvements can be made in preventing them. In addition to well-known infection-control steps such as hand-washing and the use of masks, gowns and gloves, interventions such as starting and stopping antibiotics at the right time and the application of antibiotic ointment prior to surgery are becoming more commonly used. But more can be done in a multi-disciplinary collaborative approach that involves all appropriate hospital departments, and ultimately patients.
If we apply “best practices” across an entire institution to prevent infections, from the earliest pre-operative procedures through surgery, post-op and follow-up treatment, both inside and outside the hospital, could we achieve a goal fifty percent fewer infections?
As chair of the committee on health services of the University of California Board of Regents, I am familiar with the rising cost of healthcare and the multiple ways the University of California’s health system is striving to both contain costs and improve the quality of patient care. And I believe we can help attain these goals through a new innovative pilot program at UCLA called the Surgical Infections Quality Improvement Project, to develop a simple, straightforward set of guidelines that could be applied by an entire institution to prevent SSIs.
According to Dr. Richard J. Shemin, Robert and Kelly Day professor and chief of cardiothoracic surgery at UCLA, who will oversee this pilot project, one of the most feared complications after heart surgery is infection, since deep infections around the heart can be life-threatening. The goal with this pilot project is to use evidence-based science to figure out what really works in preventing infections and create a system that surgical teams everywhere can adopt as a reliable practice standard. UCLA has adopted these techniques and have very low infection rates.
The principal investigator of the pilot project, Dr. Daniel Z. Uslan, an assistant professor in the division of infectious diseases at the David Geffen School of Medicine, believes that this pilot project is urgently needed and timely because today the bacteria most common in surgical site infections are becoming increasingly resistant to treatment. What’s more, the current treatment options can be limited, resulting in an increase in deaths due to antibiotic-resistant bacteria.
UCLA is a good starting point for these efforts, because their team -- from the CEO, to the surgeons and staff -- is committed to developing a model program that works and can be replicated at other hospitals around the country.
If the U.S. really wants to be a global leader in health care, then we need to pay far more attention to disease prevention. It is time for doctors and hospitals to be held accountable. Finding a way to stop many of these surgical site infections is doable, and won’t require years of research, developing new drugs or creating high-tech surgical techniques.
With effective protocols, we can create a model program that could be established at hospitals nationwide. It could save lives, millions in health care expenditures and untold suffering.
Sherry Lansing is the founder and current chair of the Sherry Lansing Foundation, a philanthropic organization focusing on cancer research, health and education. Ms. Lansing was the chair and CEO of the Motion Picture Group of Paramount Pictures from 1992 to 2005, where she oversaw the release of more than 200 films including Academy Award winners Forrest Gump (1994), Braveheart (1995), and Titanic (1997). A pioneering studio executive, Lansing is the first woman in the film industry to oversee all aspects of a studio’s motion picture production. Among many honors, she is a recipient of the Horatio Alger Humanitarian Award (2004), and the Jean Hersholt Humanitarian Award, which was presented to her at the 79th Annual Academy Awards. Ms. Lansing and husband William Friedkin are donors for the UCLA Surgical Infections Quality Improvement Project.