Moving to the next level, Preventing Healthcare Associated Infections!

Honorable Governor Edmond G. Brown Jr.                                                             February 24, 2014

The Great State of California

c/o State Capitol, Suite 1173                

Sacramento, CA 95814

 

Dear Governor Brown,

Thank you for your interest in patient safety, I really appreciated it. My advocacy for the Prevention of Healthcare Associated Infections(HAI) in our Veteran’s Administration Hospitals (VAH), according to the U.S. Department of Health and Human services, a preventable disease, is devoted to supporting those who help others, much like yourself, “thank you”! This letter was originally addressed to Mr.  Tom Garcia, Senior Field Representative for the Honorable Assembly member Rocky Chavez, a fellow Marine, after passively mentioning my advocacy to Mr. Garcia at a recent Chamber of Commerce networking lunch, I commented about Assembly member Chavez’s  commitment to supporting Veterans and he asked me to provide more information about my advocacy and let me know that the Assembly member Chavez is now on the health committee. Sorry about the length and challenges brought forward, opportunity is upon us, please forgive my direct approach, my time is limited, perhaps our common ground.

The impact of HAI in our VHA , for the most part, is not reported, although there is interest from several groups supporting more transparency. My only opportunity to support the VAH is to improve the entire healthcare system in California via “Best Practices”, a product of “evidence based medicine”, being collected and posted in a “Database of Best Practices for the Prevention of HAI” at the California Department of Public Health(CDPH), covered by the freedom of information act, based on the concept of the U.S. E.P.A.’s Puget Sound Storm Water Runoff Best Management Practices and challenged world-wide to be continually improved and monitored by an already funded state of the art monitoring system at the CDPH.

 One hospital in California has not had a case of Centerline Associated Bloodstream Infections(CLABSI) in nearly eight(8) years yet thousands will lose life or limb per annum  in California let alone the fiscal cost.

Let’s consider a known “best practice” to prevent CLABSI, at the federal level the VA is awaiting feedback concerning “best practices”  from the USDHHS who are awaiting and sometimes funding  the development of "best practices” at the state level, the federal VA will then advise the regional VAH  concerning “best practices” who are also watching for state level developments.

 The problem, California is not developing or accepting “any” best practices for the prevention of HAI and the CDPH avoids, at all cost, the term “best practice”. The only possible reason for the CDPH, a fully California taxpayer funded entity, to not facilitate “best practices” is their very cloudy relationship with the U.C. medical system, another asset of the California taxpayers, they seem to share addresses and nearly all of their staff have a history in the UC system.  Recently, one of the UC hospitals received an “F”, the lowest possible score, for patient safety from the Leapfrog group, a privately funded monitoring system, the CDPH monitoring system reports only if a facility is improving or regressing with no indication of current status despite the fact that they do collect the statistics. The fact that the U.C. medical system is a “teaching” system, one excuse used to defend the poor rating, does not bode well for the taxpayer or patients across the state. The CDPH’s claim that “more than half of the CLABSI cases are preventable” virtually “green-lights”  some form of socially acceptable statistics concerning the needless loss of life and fiscal waste in our state. The most profound impact of the lack of commitment at the CDPH to any “best practices” is every healthcare facility has to create their own “best practices”, replicated hundreds of times across our state, it is hard to imagine what criteria is used to train staff or the entropy caused by budget cycles and turnover. 

  Recently the Federal O.S.H.A.  has declared an interest in developing and adapting “best practices” concerning patient and workplace safety leaving the efforts at  the CDPH highly questionable and virtually irrelevant.

 The actual plan to combat HAI at the CDPH is to use their monitoring system to identify failing systems and flood them with staff and resources they do not have to bring them back to socially acceptable statistics, how this will  “prevent “ HAI completely eludes common sense.

 Organized labor is dong next to nothing in our state concerning sending their members into a needlessly dangerous workplace, the Honorable Governor Brown’s “Let’s get healthy California” is a good start, HAI is prevented by a highly motivated and empowered healthcare staff member accepting a leadership role in the implementation of a known “best practice”, nothing more, nothing less and this will not happen without a commitment from organized labor to educate and empower their members accordingly.

 The CDPH has a legal responsibility to prevent HAI, a preventable set of diseases, and should be much more aggressive concerning patient safety verses their currently defensive posture, they need to choose between protecting the bottom line of state assets or protecting California citizens from preventable diseases and massive amounts of fiscal waste in our healthcare system.

 Do we have the “will” to prevent HAI, your interest leads me to believe we do, the technology and “best practices” are already there and once again, thank you for your interest and yes, the term “Best practice” is the key, we have “control guidelines”, “guidelines for prevention” and “recommendations” but never the term “best practice”, hopefully you as the Honorable Governor will at least get the respect of an answer which I have not receive in over two years of humbly asking the staff at the CDPH.

Respectfully,

 

Michael H. Slavinski                                              http://h-a-i-5.blogspot.com

 

cc:

Honorable California Senator Ed Hernandez

Chair, Committee on Health Care

 

Honorable  California Senator Mark Wyland

 

Honorable California Senator William W. Monning

 

Honorable California Assembly member Rocky  J. Chavez

 

Honorable California Assembly member Katcho Achadjian

 

Diana S. Dooly

Secretary

California Department of Public Health

 

Ms. Kathleen Billingsley

Chief Deputy Director

California Department of Public Health

 

Ms. Debbie Rogers, RN, MS, FAEN

Deputy Director

Center For Health Care Quality

 

Ms. Dana Woods

CEO,

American Association of Critical Care Nurses

 

SEIU-UHW

Executive Board

 

Mr. Chuck Idelson

Communication Director

California Nurses Association

 

Mr. Tom Garcia

Senior Field Representative for the Honorable Assembly member Garcia

 

Mr. Eddie W. Hartenstrin

Publisher and Chief Executive Officer, Los Angeles Times

Publisher and Chief Executive Officer,Tribune Company

 

Ms. Pam Kehaly

Chief Executive Officer,

 Anthem Blue Cross

Staff, Anthem Blue Cross

"If we can improve the quality of care, that will translate into lower cost," Anthem President Pam Kehaly said. "These are real dollars."

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Happy kids, courtesy US Peace Corps