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Source: http://www.thespec.com/News/Local/article/437071
How other countries fight C. diff
September 18, 2008
Joan Walters
The Hamilton Spectator
(Sep 18, 2008)
Outside Ontario, rising death and infection rates from a vicious new strain of the superbug C. difficile have prompted governments to call inquiries, impose fines, offer incentives and take other action to bring the disease under control.
In the United States, Medicare officials asked this summer for public comment on a plan to hold back payments to hospitals for the extra care required for patients harmed by certain preventable infections -- including C. diff.
The U.K. has imposed fines of up to $100,000 and warned of reduced funding for hospitals that cannot hit government-imposed targets to bring C. diff infection rates down.
Around the world, rising public anxiety and warnings from health watchdogs have led other jurisdictions to act aggressively.
In Ontario -- where hundreds of infected hospital patients have died in just the past two years -- the government takes its first formal steps against the bug next week with the launch of mandatory reporting on hospital C. diff infection rates.
But Ontario's C. diff death rate, which went up 50 per cent from 2005 to 2007, indicates more is needed, critics of the government say.
A tally by The Spectator shows at least 460 patients infected with C. diff have died at just 22 of Ontario's 157 hospitals since 2006. In the worst of those outbreaks, 91 patients died at Joseph Brant Memorial Hospital.
But the Ontario government has declined to find out on its own how many patients have died provincewide. It has also rejected calls for any investigation or inquiry into what went wrong with the province's infection controls.
"Family after family after family went through hell and back in dealing with these outbreaks and the government pretty much tried to have an arm's-length approach," says New Democrat Andrea Horwath, MPP for Hamilton Centre.
"That is absolutely unacceptable when people were dying."
And the new C. diff reporting system that launches Sept. 26 will only look at what happens from this point forward, not what occurred in the past. It will not count deaths, either, meaning the public will not be able to see whether C. diff fatalities rise -- as they have in other countries.
Investigations into the circumstances surrounding as few as 20 deaths from C. diff have been called in England, Scotland, Wales and Northern Ireland.
Other initiatives include:
* Notice of fines of up to $100,000 has been posted by Britain's National Health Service for hospitals that breach hygiene regulations. The fines also cover infractions such as obstructing a government inspector and failing to provide requested documents.
* British inspectors will now have the power to prosecute hospitals and clinics -- for example, if they fail to take requested action after an outbreak of C. diff.
* Doctors and other health workers in Britain have a "bare-below-the-elbows" dress code: no ties, shirt cuffs, rings or watches. C. diff spores can survive on clothing and other surfaces.
* U.K. hospitals with declining C. diff rates can apply to an incentive fund for up to $500,000 for new hygiene initiatives, such as extra handwashing basins.
* Earlier this year in Northern Ireland, the health minister took less than a month to order a review and set in motion an action plan after 51 patients in one hospital district died of C. diff. An expert panel was retained for a three-month investigation of what went wrong, and $18 million was found for special infection-fighting measures, including unannounced hygiene inspections of hospitals.
Northern Ireland has also set a target of a 20 per cent reduction in C. diff in the elderly by mid-2009.
* The European Centre for Disease Prevention and Control called this summer for a review of existing guidelines for C. diff control, after outbreaks of the epidemic strain in 16 countries there.
* A symposium of clinical microbiologists in Europe called this spring for strong efforts to find new therapies for the bacterium.
How other countries fight C. diff
September 18, 2008
Joan Walters
The Hamilton Spectator
(Sep 18, 2008)
Outside Ontario, rising death and infection rates from a vicious new strain of the superbug C. difficile have prompted governments to call inquiries, impose fines, offer incentives and take other action to bring the disease under control.
In the United States, Medicare officials asked this summer for public comment on a plan to hold back payments to hospitals for the extra care required for patients harmed by certain preventable infections -- including C. diff.
The U.K. has imposed fines of up to $100,000 and warned of reduced funding for hospitals that cannot hit government-imposed targets to bring C. diff infection rates down.
Around the world, rising public anxiety and warnings from health watchdogs have led other jurisdictions to act aggressively.
In Ontario -- where hundreds of infected hospital patients have died in just the past two years -- the government takes its first formal steps against the bug next week with the launch of mandatory reporting on hospital C. diff infection rates.
But Ontario's C. diff death rate, which went up 50 per cent from 2005 to 2007, indicates more is needed, critics of the government say.
A tally by The Spectator shows at least 460 patients infected with C. diff have died at just 22 of Ontario's 157 hospitals since 2006. In the worst of those outbreaks, 91 patients died at Joseph Brant Memorial Hospital.
But the Ontario government has declined to find out on its own how many patients have died provincewide. It has also rejected calls for any investigation or inquiry into what went wrong with the province's infection controls.
"Family after family after family went through hell and back in dealing with these outbreaks and the government pretty much tried to have an arm's-length approach," says New Democrat Andrea Horwath, MPP for Hamilton Centre.
"That is absolutely unacceptable when people were dying."
And the new C. diff reporting system that launches Sept. 26 will only look at what happens from this point forward, not what occurred in the past. It will not count deaths, either, meaning the public will not be able to see whether C. diff fatalities rise -- as they have in other countries.
Investigations into the circumstances surrounding as few as 20 deaths from C. diff have been called in England, Scotland, Wales and Northern Ireland.
Other initiatives include:
* Notice of fines of up to $100,000 has been posted by Britain's National Health Service for hospitals that breach hygiene regulations. The fines also cover infractions such as obstructing a government inspector and failing to provide requested documents.
* British inspectors will now have the power to prosecute hospitals and clinics -- for example, if they fail to take requested action after an outbreak of C. diff.
* Doctors and other health workers in Britain have a "bare-below-the-elbows" dress code: no ties, shirt cuffs, rings or watches. C. diff spores can survive on clothing and other surfaces.
* U.K. hospitals with declining C. diff rates can apply to an incentive fund for up to $500,000 for new hygiene initiatives, such as extra handwashing basins.
* Earlier this year in Northern Ireland, the health minister took less than a month to order a review and set in motion an action plan after 51 patients in one hospital district died of C. diff. An expert panel was retained for a three-month investigation of what went wrong, and $18 million was found for special infection-fighting measures, including unannounced hygiene inspections of hospitals.
Northern Ireland has also set a target of a 20 per cent reduction in C. diff in the elderly by mid-2009.
* The European Centre for Disease Prevention and Control called this summer for a review of existing guidelines for C. diff control, after outbreaks of the epidemic strain in 16 countries there.
* A symposium of clinical microbiologists in Europe called this spring for strong efforts to find new therapies for the bacterium.
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