Infection Control, Physicians’ Offices, and Our Health May Be in Serious Jeopardy

The Federal Trade Commission is expected to begin investigating corporate consolidation into mega entities as they purchase increasing numbers of companies. Federal agencies are also investigating the growing influence of private equity and other firms in the healthcare industry. This investigation aims to shed light on how specific healthcare market transactions might lead to more consolidation, more profits for businesses, and worse healthcare for patients and taxpayers in terms of quality and affordability.

One concern is the changes in staffing levels to ensure adequate patient safety and care, especially during overnight shifts. One hospital has purchased all the single caregiver’s medical practices and eliminated any MD coverage in overnight hours. The only individual responsible for the entire hospital was a nurse clinician.

Patient care and staff, as well as other aspects of healthcare, have raised issues of concern for patients, caregivers, healthcare professionals, and federal agencies. How many patients are aware of the necessity for a hospital unit to be responsible for infection control? It is sometimes referred to as “universal precautions.” This becomes particularly concerning when patients are unaware of it. Research has shown that hospitals are a major contributor to infections that can be transmitted to the home after discharge.

Most cases of these infections occur within the first 48 hours of hospitalization. Many hospitals have implemented infection tracking and surveillance systems and strong prevention initiatives to address hospital-acquired infections. In the early 20th century, healthcare professionals began to pay more attention to hospital-acquired infections. The concern remains.

It is estimated that the National Health Service (NHS) spends around £1 billion each year treating 300,000 patients in England with healthcare-associated infections (HCAIs), according to NICE. Potential causes include cross-contamination among hospital staff or contaminated equipment and other things.

The Problem Persists

Hospitals and patients alike continue to worry about SSIs, even though there has been a great deal of research and development in medical treatments for them over the past few decades. One study found that the reported incidence of surgical site infections (SSIs) has stayed relatively constant over the last fifty years, which raises questions about their relevance and the necessity of investigating the financial impact of SSIs on healthcare systems and individual patients. How common is a hospital acquired infection?

One in thirty-one hospitalized patients experience a HAI at any one moment, with a daily cost of up to $123 million, according to the CDC. Whether the last patient in the room had an infection nearly quadruples the patient’s risk of contracting a HAI. In order to reduce HAIs, it is essential to clean and disinfect thoroughly. Usually, there is an infection control person, normally a nurse or someone of similar certification and education, who would make regular inspections of the areas and hold meetings with staff to address any areas of concern.

But what about individual medical practice routines? How might individual medical practice routines contribute to transporting infections from the office to another setting, and what actions can be taken to address this? How much research has been conducted on this? The question would seem to be related to how effective the hospital-acquired practices are regarding infection control at these sites.

Allow me to provide some personal information that I have gleaned from visits to various sites. Note that I was not there for any type of investigatory process but simply to accompany a patient.

At one facility, with about eight exam rooms and an entry through an 8-foot-high glass door without a handicap-accessible button, it was clear that infection control was not being addressed. The unit that was to dispense a hand cleanser had a note on it that said, “Not working.” So, hand cleansing at the door entrance was not possible.

A significant medical center in the area owns the practice and has now incorporated the patient caseloads from most individual practitioners’ practices into its infrastructure. The hospital informs any physician who does not wish to sell their practice that they will no longer receive referrals or privileges.

Inside, the exam chairs for patients were neither cleaned before nor after patient visits. A technician, not wearing gloves, returned sterilized instruments to a drawer. Despite our usual attention to patient privacy, they failed to close the exam room doors during procedures. It was the patient’s request that the door be closed that resulted in that action.

After completing the procedure, the attending physician, who was using instruments, failed to wash their hands before putting on surgical gloves and left everything strewn across a tray. Before and after the procedure, the physician did not disinfect the area that would be treated.

Additionally, the generated report falsely indicated that a blood pressure reading of 120/60 was recorded when, in fact, no one recorded any blood pressure. I can only suppose that the physicians use a boilerplate template, and it includes standard measurements that are never taken with each patient. Is this ethical?

I have also been to an ophthalmologist’s office where a sink has never been used, which is obvious because items are stored in the sink’s basin area. This person, without any gloves, touches patients’ faces and eyes regularly and has a large, long-standing practice in the area. He also does corrective eye surgery at an outpatient surgical center, where the staff behavior is unacceptable. They laugh and yell at extremely high volumes and seem to be under little management control.

What Can Patients Do?

Patient safety must be a concern for everyone, not just the patients themselves. Many things happen in medical settings that come under the purview of an agency or organization that certifies that facility. Usually, there is a means for patients to report safety concerns, and one is through the Joint Commission, which provides a way to address these matters.

Patient safety is of prime concern to the organization that certifies 15,000 healthcare organizations and has an agreement to verify 4,600 programs. Patients can directly address pertinent issues by searching for individual organizations on their website.

Often, the problem may be a lack of documentation or of receiving adequate information before any procedure or even suicide prevention. But it can also be a matter of infection control within an accredited facility.

You can also contact the US Department of Health and Human Services with any concerns about the quality of medical care. The website of the Quality Improvement Organizations, which serves Medicare patients, is another area where information or complaints may be reported.

Any patient, caregiver, or healthcare professional who has observed instances of care or treatment has recourse at the indicated organizations noted here. No one is helpless, and there are ways to address these issues.