Simple Hand Hygiene Measures Reduce Infections and Costs

The number one condition hospitals spend money on is treating sepsis.  In 2011, hospitals billed Medicare for 772,000 case of septicemia that cost hospitals $12.6 billion according to figures from the Health Cost and Utilization Project. Hospital-associated infections (HAIs), of which sepsis is one, are a major component of rising hospital costs.The Centers for Disease Control (CDC) estimate that the direct medical costs of these  infections ranged from $36 billion to $45 billion per year.

Hand Hygiene

“Hand hygiene is the most important intervention to reduce the risk of hospital associated  infections,” according to Dr. Leonard Mermel, Medical Director of the Department of Epidemiology and Infection Control at Rhode Island Hospital.  Dr. Mermel conducted a study that showed hand hygiene compliance increased from 60 percent to 89 percent from July 2008 to December 2012 at Rhode Island Hospital.  The study found that there was greater hand hygiene compliance  (1) when health care workers left patient rooms, (2) when entering or leaving a room with a patient who was known to be infected with an antibiotic-resistant bacteria, and (3) during evening shifts.

Increasing Compliance

A recent study showed that providing health care workers with a personal hand sanitizer that they could carry with them greatly increased compliance with hand hygiene protocols.  Health care workers complied with hand hygiene policies 53 percent of the time before contact with a patient and 72 percent of the time following contact with a patient when they carried a pocket-size hand sanitizer.  This was an increase from 23 percent compliance with hand hygiene policies before patient contact and 43 percent compliance with hand hygiene policies for post patient contact before the personal sized gel containers were distributed.

The New York Times reported earlier in the year that North Shore University Hospital on Long Island used motion sensors at the entrance to rooms of patients receiving critical care that triggered automated cameras to see if hand hygiene policies were followed.  Other hospitals are using identification badges that contain a chip in them that goes off if employees pass by sinks or other places where their hands could be sanitized. Monitoring seems to be the key. The New York Times reported that when employees of North Shore University hospital did not know they were being monitored they followed hand hygiene procedures only 10 percent of the time, but when they were informed that they were begin recorded compliance jumped to 88 percent.

Upcoming Payment Penalties

Beginning on October 1, 2015, the top 25 percent of hospitals treating patients with HAIs will have their reimbursements reduced by 1 percent.  The CMS program includes conditions other than conditions that arise from bad hand hygiene, but good hand hygiene will reduce the frequency of a number of the HAI conditions on the list that CMS will use to make the payment reduction; with the rate of sepsis being one of the conditions monitored.  The reduction in payment for fiscal year 2015 will be based on the number of conditions reported from July 1, 2011 to June 30, 2013.

Simple programs such as hand-washing and hand hygiene practices can result in big savings for hospitals.  The challenge will be to get health care providers to comply with these policies and procedures, and that too can be achieved by such simple things as active monitoring or supplying sanitizing gel in containers that health care providers can carry. Reducing these infection will not only save money, but will improve health care.