State health regulators yesterday approved a sweeping crackdown designed to stem the spread of infections inside hospitals, a crisis blamed for thousands of patient deaths and millions of dollars in unnecessary medical expenses.
The Public Health Council voted unanimously to dispatch state inspectors regularly to hospitals to make sure they are following rules on preventing infections and reporting them promptly when they happen. And the panel also approved a plan to issue report cards on infection rates for each hospital and to post that information on a state government website.
A hospital that failed to comply with the rules or continued to have an excessive number of infections could forfeit its license, said state Public Health Commissioner John Auerbach.
"We're going to take the regulations very seriously," Auerbach said. "Our expectation is the hospitals will be very cooperative."
A state report last summer found that potentially lethal infections contracted during hospital stays could be responsible for up to $473 million in medical costs annually in Massachusetts, a reflection of extended hospital stays and medication and surgical costs. National studies estimate that up to 90,000 patients a year die because of infections they catch while in medical facilities, with deadly germs gaining entry through surgical incisions and catheters and sometimes transmitted by doctors and nurses who fail to wash their hands.
After years of scant attention, infections have become central to the growing movement to improve patient care and make the operations of hospitals more transparent. More and more, hospitals are paying for their mistakes: Some facilities have voluntarily stopped charging for costs related to preventable infections, and later this year, Medicare will halt payments for conditions linked to mistakes.
Auerbach said the state expects to begin inspections and collecting data on infection rates within three to six months. It's less clear, he said, when the information will be posted on a website, in part because the Department of Public Health and another agency are considering combining quality data on a single site.
Initially, the online report card will be limited to infections caught by patients who have undergone knee and hip surgery, as well as patients who have had central venous catheters inserted in intensive-care units. The catheters are typically placed in the arm or neck and threaded to big veins near the heart. They remain in place for days or weeks and can be used to deliver chemotherapy or thick mixtures of liquid food. They can also deliver dangerous germs deep into the body.
Those procedures are conducted so commonly that they allow for reliable hospital-to-hospital comparisons. Ultimately, regulators expect to make other infection rates public through the online report card.
The two most powerful voices on public health matters on Beacon Hill pledged yesterday to place the Legislature's financial and political muscle behind the crackdown.
"People shouldn't go to the doctor's office or the hospital afraid that they'll leave sicker than when they arrived," said state Senator Richard T. Moore, an Uxbridge Democrat who is chairman of the Joint Committee on Health Care Financing.
State Representative Peter J. Koutoujian, chairman of the Joint Committee on Public Health, said at least two members of the Legislature have approached him with their own heart-rending stories about family members who caught serious infections while in the hospital.
"This is something that has reached so far into our society," said Koutoujian, a Waltham Democrat, "and yet we're just catching up with it."
The leading confederation of hospitals in the state also issued its unqualified support for the regulations. Karen Nelson, senior vice president for clinical affairs at the Massachusetts Hospital Association, said administrators have become increasingly comfortable with opening the window to public scrutiny of quality and safety records.
"Hospitals know they have accountability for errors, they know they have accountability for infections," Nelson said.
But Julie Pinkham, executive director of the Massachusetts Nurses Association, said the state regulations and hospitals' vow to abide by them are doomed to failure unless an underlying problem is addressed: inadequate staffing.
"This is not a silver bullet," Pinkham said. "It's missing the target altogether. People are running around out there with their head cut off because of staffing problems, and that's resulting in poor practice and that's resulting in poor outcomes."
Stephen Smith can be reached at stsmith@globe.com.
