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Despite opposition by hospitals and the state Department of Health, Gov. Jay Inslee sided with patient advocates Tuesday to retain a requirement that hospitals report infections resulting from hip and knee replacements and cardiac surgeries.

The new law, enacted by HB 1471, requires hospitals, which have had to report those infections since 2007, to continue for another four years.

It also expands reporting to include central-line infections in all hospital areas, rather than just in intensive-care units, and infections resulting from colon surgery.

Central lines are tubes placed in patients to put fluids, blood products, chemotherapy and other drugs directly into the bloodstream.

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The bill was passed unanimously by both the House and Senate earlier this year.

Inslee spokeswoman Jaime Smith said Inslee prefers greater transparency in health care and believes such infections can lead to serious harm.

The Washington State Hospital Association (WSHA), backed by the state Department of Health, argued to the governor that hospitals need to streamline their reporting requirements by aligning with federal requirements, which do not include reporting infections from hip and knee replacements or cardiac surgery.

“The reporting system is very cumbersome,” said Cassie Sauer, WSHA’s senior vice president for advocacy and government affairs.

In addition, Sauer said, infection rates for those procedures are low, differences among different hospitals are statistically insignificant and the information isn’t very useful to the public without national comparisons.

Inslee apparently sided with Consumers Union and local patient advocates, who argued that hip, knee and cardiac surgeries were among the most common procedures in many hospitals, and in many cases are elective, meaning that patients might choose among


“Because these surgeries are so common, consumers want to know about their associated infection rates,” Consumers Union noted in a letter to Inslee.

In addition, the group said that although the surgeries have been included in state infection-reporting law since 2007, consumers have so far seen only one year of data.

“Hospitals are trying to eliminate this reporting requirement because they claim it is too much of a burden,” said Lisa McGiffert, director of Consumers Union’s Safe Patient Project.”
But we think they are really critical procedures for public reporting.”

Local patient advocate Yanling Yu, of Lake Forest Park, also weighed in, telling Inslee’s policy advisers that because of the high volume of such surgeries anticipated in the near future, many patients could potentially be affected by infections.

According to the Centers for Disease Control and Prevention, there were more infections from either hip- or knee-replacement surgery among reporting hospitals in 2011 than from any other procedure except colon surgery.

McGiffert noted that hip- and knee-replacement surgeries, typically done on healthy patients in areas of the body that typically do not harbor pathogens, are so-called clean procedures that should never result in infections.

McGiffert, who has been working for several years to increase public reporting of infections by hospitals, said hospitals often resist reporting.

“When we started out with (reporting) implementation, every hospital association in every state complained about how much trouble it was to collect central-line data — they didn’t have a system, it takes too much time … Now they have a system. They’re never going to come up with a system until they have to.”

The bill, as signed by Inslee, removes the hip-, knee- and cardiac-surgery-infection-reporting requirement after 2017. McGiffert said her group does not object to that because five years of data will be sufficient for consumers to see trends and differences among hospitals. The bill, as signed, also gives the Health Department authority to align state and federal requirements in the future.

Sauer said hospitals in this state are dedicated to reducing infections and will work with the state to implement the law, which will give consumers more information about both central-line and colon-surgery infections, the latter often difficult to prevent.

“Hospitals will be able to compare infection rates in those new areas with other hospitals across the country,” she said. “ In four years, the federal- and state-infection reporting will be in sync, which will allow for meaningful comparisons and streamlined reporting processes.”

Carol M. Ostrom: or 206-464-2249. On Twitter @costrom

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