September 2, 2010
Department of Public Health Through Public Records Act Request
SAN FRANCISCO, CA – Nearly half of all hospital workers in California did not get vaccinated for influenza during the 2008-2009 flu season, according to a new report released by the Safe Patient Project of Consumers Union, the nonprofit publisher of Consumer Reports. The report is being released at the start of the flu season and is based on data that the Department of Public Health is required by law to collect and publish. The state has not provided the information to the public but it was obtained by Consumers Union through a Public Records Act request.
View the full report here.
“For nearly twenty years, the CDC has recommended that all healthcare workers should be vaccinated for the flu to prevent its spread to patients under their care,” said Lisa McGiffert, Director of Consumers Union’s Safe Patient Project (www.SafePatientProject.org). “But we found that almost half of all healthcare workers in California failed to take the simple step of getting the influenza vaccine despite all the evidence that proves it will reduce flu outbreaks in hospitals.”
The Centers for Disease Control and Prevention has recommended influenza vaccination of healthcare workers, including doctors, with direct patient contact since the early 1980s and for all healthcare workers since 1993. Studies have shown a significant relationship between vaccination rates among hospital workers and the rate of healthcare-acquired influenza among patients. When patients who are already sick develop the flu in the hospital, the consequences can be significant. The median mortality rate during hospital-acquired influenza outbreaks in acute care facilities has been documented at 16 percent with an average additional cost of $7,500 per case.
Under legislation passed by state lawmakers in 2006, California hospitals have been required to offer on-site influenza vaccines to all hospital employees at no cost. Starting in January 2008, hospitals were required to report to the Department of Public Health the number of employees who were vaccinated along with the number who have declined the vaccination. The California Department of Public Health was supposed to publicly report influenza vaccination rates by hospital for the 2008-2009 flu season by March 2010 but never did so.
Earlier this year, Consumer Union submitted a Public Records Act request with the Department to find out how much progress had been made by the state to implement recently enacted patient safety laws. Included in the request was the data collected from hospitals on influenza vaccination rates.
According to the Department of Public Health, 299 hospitals reported influenza vaccination rate data or 69 percent of the 432 licensed general acute facilities in California. One hundred and thirty six hospitals did not report data to the Department or 31 percent of the licensed general acute care facilities in California. The Department has indicated that it may have lost some of the submitted records and that some hospitals may have been confused about the data they were required to report.
“It appears that either a large number of California hospitals failed to report their flu vaccination rates as required by law or that the state has a very sloppy record-keeping system,” said McGiffert. “Our analysis reveals a system that lacks accountability for implementing the law and fails to provide accurate patient safety information on all hospitals. Californians have a right to know how their hospital stacks up when it comes to protecting patients from influenza.”
Based on data from 246 reports provided by the Department of Public Health, Consumers Union’s Safe Patient Project found that:
• The average vaccination rate reported by hospitals was 52.4%.
• 3.3% of hospitals had vaccination rates of less than 25%.
• Two-thirds of hospitals had vaccination rates of less than 60%, the 2010 target set by the U.S. Department of Health & Human Services
• One third of hospitals had vaccination rates greater than 60%.
• Only 1.6% of hospitals had vaccination rates greater than 80%, the rate suggested by some experts as necessary to prevent in-hospital transmission.
“Hospitals aren’t doing enough to protect patients from developing infections that can make them sicker during treatment,” said McGiffert. “While some hospitals have aggressive vaccination programs, most do not. A fifty-two percent vaccination rate is unacceptable. Reporting this information to the public will motivate hospitals to work harder to protect patients by boosting vaccination rates among healthcare workers.”
In particular, Consumers Union’s Safe Patient Project recommended that the Department of Public Health should:
• Publish vaccination rates of each California hospital for the 2008-2009 flu season and should publish rates for the 2009-2010 flu season, and for all future flu seasons, within the statutory timelines.
• Require the CEO of each hospital to sign an affidavit stating the data submitted is accurate.
• Require all hospitals to report using standardized forms and definitions and should check the accuracy of the data through random reviews of hospital immunization records.
In March 2010, Consumers Union released a report entitled “Preventable Harm,” which detailed how the Department of Public Health has been slow to implement many of the key provisions of a number of patient safety laws.
Michael McCauley – 415-431-6747