Secretary Sebelius Highlights Two New Reports on Health Care Quality, Says Improving Quality is Key Component of Health Reform

At a speech before the United Nurses of America's 12th National Nurses Congress, Secretary Kathleen Sebelius today discussed two new HHS reports on the quality of health care in America and challenged hospitals to work to reduce health care associated infections. Published by the Agency for Healthcare Research and Quality, the annual 2008 National Healthcare Quality Report and 2008 National Healthcare Disparities Report indicate that patient safety measures have worsened and that a substantial number of Americans do not receive recommended care. Upon issuing the reports, Sebelius also announced the availability of $50 million in Recovery Act resources to fight health care associated infections and improve patient safety.

"Today's reports show why we can't wait to enact comprehensive health reform," said Sebelius. "The status quo is unsustainable and we cannot allow millions of Americans to continue to go without the care they need and deserve."

The reports found:
* 40 % of recommended care is not received by patients.
* Only 40% of diabetic patients received three recommended diabetic preventive exams in the past year, and this rate has not improved over time.
* Only half of obese adults and children are given advice to exercise more and eat a healthy diet.
* Seven out of ten adults with mood, anxiety, or impulse disorders received inadequate treatment or no treatment at all.
* Disparities in health care persist. Minority patients receive disproportionately poor care compared to Caucasian patients. At least 60 percent of quality measures have not improved for minorities compared to Caucasians in the past six years.
* One in seven hospitalized Medicare patients experience one or more adverse event.
* Patient safety measures have worsened by nearly 1% each year for the past 6 years.
* Central line associated blood stream infections (CLABSIs) strike hundreds of thousands of patients each year.

Patient safety has declined in part because of this rise in health care associated infections (HAI), infections that patients acquire during the course of their stay in a healthcare setting, such as a nursing home or a hospital. HAIs are among the top ten leading causes death in the United States, and drive up the cost of health care by up to $20 billion per year.

Sebelius today announced that the Department of Health and Human Services plans to make $50 million in grants funded by the American Recovery Act available for states to help fight healthcare-associated infections (HAI). HHS plans to make $40 million available through competitive grants to eligible states to create or expand state-based HAI prevention and surveillance efforts, and strengthen the public health workforce trained to prevent HAIs. HHS is also allocating $10 million in grants to states to improve the process and increase the frequency of inspections for ambulatory surgical centers.

"Healthcare-associated infections can make illnesses worse, further debilitate patients who are already struggling and sometimes lead to death," said Sebelius. "Through the funding provided by the Recovery Act, we can help prevent these infections and improve the quality of care for all patients."

Sebelius also called on hospitals across America to commit to reduce Central Line Associated Blood Stream Infections in Intensive Care Units by 75 percent over the next three years. Research indicates that these infections strike hundreds of thousands of surgical patients and the percentage of patients acquiring these infections has steadily increased over the past six years.

Sebelius challenged hospitals to make use of a proven patient-safety checklist that can significantly and dramatically reduce the rate of these life-threatening infections.

"Patients expect to get better in a healthcare facility, not worse" added Sebelius. "The Recovery Act money will help protect patient safety, but we need hospitals to do more. Today, I'm challenging hospitals to take basic steps to fight infections that are weakening our health care system and threatening patient safety."

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Statement by HHS Secretary Kathleen Sebelius and Acting CDC Director Dr. Richard Besser Regarding the Change in CDC's School and Childcare Closure

Statement by HHS Secretary Kathleen Sebelius and by Acting CDC Director
Dr. Richard Besser

Since the beginning of this outbreak, the CDC has been working to
update, or in some cases, quickly develop interim guidelines to help
healthcare providers, health departments and communities take effective
action to prevent the spread of this novel H1N1 virus. In doing so, we
acknowledged that our interim guidelines would be based on the data
available at the time, be guided by science, and designed so that
resources and efforts would be directed toward actions and activities
that would make a difference in preventing spread of this virus. If new
information or developments indicated a need to adjust our guidance, we
indicated we would do so.

Today, we are announcing a change with respect to CDC's interim guidance
on closing schools and childcare facilities. The initial guidance CDC
issued on May 1st recommended that affected communities with
laboratory-confirmed cases of influenza A H1N1 consider adopting school
dismissal and childcare closure measures, including closing for up to 14
days depending on the extent and severity of illness. At the onset of
this outbreak of a previously unknown influenza virus, we believed it
could be helpful to close affected schools while we learned more about
the virus's transmission and the severity of disease. Further, the U.S.
national strategy for pandemic influenza suggested that ongoing
community-wide closure of all schools and daycare centers should be
considered in the event of a severe outbreak, especially if these
measures could be implemented early.

As CDC's daily press briefings have illustrated, much has been learned
quickly about the virus's severity and its spread. We now believe that
the disease currently being caused by this novel flu virus is similar to
that typically caused by seasonal influenza. Although many people will
get sick and a small number, unfortunately, may become quite ill or even
die, the available data do not indicate that this virus is causing
unusually severe influenza at this time.

With the modified policy being issued today, CDC no longer recommends
that communities with a laboratory-confirmed case of influenza A H1N1
consider adopting school dismissal or childcare closure measures.
Rather, in line with policies being undertaken in Seattle, New York and
Canada, CDC has modified its policy to recommend implementation of
measures that focus on keeping all student, faculty and staff with
symptoms of influenza out of schools and childcare facilities during
their period of illness and recuperation, when they are potentially
infectious to others.

More specifically, at this time, CDC recommends the primary means to
reduce spread of influenza in schools focus on early identification of
ill students and staff, staying home when ill, and good cough and hand
hygiene etiquette. Students, faculty or staff with influenza-like
illness (fever with a cough or sore throat) should stay home and not
attend school or go into the community except to seek medical care for
at least 7 days even if symptoms resolve sooner. Students, faculty and
staff who appear to have an influenza-like illness at arrival or become
ill during the school day should be isolated promptly in a room separate
from other students and sent home.

It's important to note that schools that were closed based on previous
interim CDC guidance related to this outbreak may reopen. That said,
decisions about school closure are at the discretion of local
authorities based on local considerations, including public concern and
the impact of school absenteeism and staffing shortages.

We appreciate the efforts that communities, particularly school
districts, have taken to protect students and staff from this influenza
A H1N1 virus. Communities and schools are at the forefront of
protecting people's health, and we are committed to providing them the
flexibility they need to deal with local conditions, and the best
possible guidance that reflects our most current understanding of the
scientific and medical facts.

Finally, we should add that there are many individuals in our
communities -- the elderly, the very young, and individuals with
suppressed immune systems -- for whom influenza represents a potentially
lethal threat. The 2009 influenza A H1N1 virus is likely to circulate
widely in our communities; if not now then almost certainly in the fall.
We all have a special responsibility during this time to protect
ourselves and protect our neighbors and others in our community by
behaving responsibly and doing whatever we can to minimize the spread of
disease. A virus that may only cause sniffles and mild inconvenience in
one person may put the next into the hospital.

We have more information on the 2009 H1N1 virus today than we did only
one week ago, but much uncertainty remains. We should all be prepared
for a potentially rocky influenza season this fall. The Administration
and the CDC will continue to actively investigate this outbreak as it
unfolds and protect the health of the American public.

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