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HAI reporting: Should it be legislated?

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So assume for the purposes of argument that hospitals do not eliminate hospital-acquired infections, and that the states in which they operate require them to begin public reporting of their infection rates — as a means of (choose your motivator) shaming them into doing better, or warning the public if they do not.

This argument is not hypothetical: Nineteen states have enacted HAI-reporting legislation, and another half-dozen have HA-MRSA reporting requirements, with more states considering MRSA bills this spring.

On the one hand, we know that infection control is difficult: Bugs linger not just in obvious places — walls, floors — but on essential objects with complex, hard-to-clean surfaces such as computer keyboards and stethoscopes. But on the other hand, we know that good infection control saves not only lives, but money and time as well.

So, infection control — specifically, “search and destroy” — by legislation: Fair or not fair?

A set of articles published last year argues the two sides. From Dr. Barry Farr, professor emeritus at the University of Virginia Health System, long-time leader in infection control: Legislation is not the best solution, but it should be enacted because the healthcare industry has been dragging its feet for too long. From the boards of directors of the Association of Professionals in Infection Control and the Society for Healthcare Epidemiology of America: Legislating specific actions that hospitals must take creates an unfunded mandate and may have unintended consequences.

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