Health & Welfare | Daily Report

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The state department that is more than six months late in publicly reporting about health worker flu vaccines has also failed to publicly report other hospital infection-related data called for in a 2006 law.

A report issued by Consumers Union last week [PDF] points out that the state Department of Public Health was mandated to report on flu vaccines given to hospital workers by March of this year, but has not.

The same law calls for such disclosure about hospital catheter-insertion practices and their track record on surgical infection control efforts.

Department spokesman Ralph Montano said the state is evaluating the best way to report the catheter-insertion data, which examines hospital efforts to reduce infections when central lines are put in patients in intensive care units.

Montano said the surgical infection data is already reported at the Medicare Hospital Compare website.

Meanwhile, Department of Public Health officials are compiling their own report on flu vaccinations among hospital workers in the wake of a critical probe by the consumer advocacy group.

Consumers Union relied on data the state supplied in June to reach the conclusion that about half of California hospital workers were vaccinated [PDF], based on data for about 70 percent of the state’s hospitals. The group filed a Public Records Act request for the information.

A state epidemiologist reported similar numbers in May [PowerPoint file]. A presentation shows that one in four hospitals were not reporting data to the state. The employee vaccine rate was about 55 percent at hospitals that are licensed individually, the presentation shows.

Despite the discussion of the data in a public meeting, state authorities sent Consumers Union data with each page marked “DO NOT CITE OR DISTRIBUTE.”

A 2006 state law mandated that hospitals offer flu vaccines to workers for free and document how many are administered and how many are refused.

Just yesterday, the American Academy of Pediatrics affirmed the importance of health workers getting such vaccines, saying they should be mandatory for doctors, nurses and other health workers. They called such a step part of workers' "ethical and professional obligations to act in the best interests of the health of their patients."

Montano said the data reflects the state's effort to clarify reporting requirements. The state sent hospitals three different flu vaccine reporting forms just during the 2008 to 2009 flu season. The series of questionnaires coincided with confusion over how to classify contract employees, part-time workers and those who got flu shots on their own.

The resulting data, which was also provided to California Watch, shows that hospitals supplied mixed numbers on the various categories of staff.

Montano said the vaccine tracking program focused on hospital activity from Sept. 1, 2008 to March 31, 2009, which is considered flu season, but was not given any state funding until December 2009.

“We had the forms, which were going through changes and edits," he said. “There was no funding and no program to support it. Once we had funding and staffing in December 2009, we began taking information that had been collected and culling through it and seeing what we had to do with data."

Montano said the department is still working with the data and plans to issue a report by the end of this month.

However, he said officials have not yet decided if the state report will cluster all hospitals together or offer the public a hospital-by-hospital look at staff vaccination rates.

The distinction is vital, said Lisa McGiffert, director of the Safe Patient Project by Consumers Union, which issued the report on the flu vaccine rates.

For one, the 2006 law mandating public reporting of flu vaccine data calls for facility-level reporting to have been made public months ago, she said.

Kate Cummings of the Department of Public Health outlined the advantages of public reporting in a May presentation about the data [PowerPoint file], saying it would give consumers information they need to make informed health decisions. They could also exercise their market power by seeking care at hospitals that are most aggressive about vaccinating workers and sending a message to others.

Yet Cummings recommended to a state committee that the data not be issued based on each facility’s performance, considering the 2008 flu season a “test year.”

McGiffert, though, said the stakes are high for patients. Her organization’s report cited one study that says the median death rate during hospital flu outbreaks is 16 percent.

“This (vaccination) is a simple step,” she said. “And when you work in contact with patients who are vulnerable and could become more ill if they got the flu, you have a responsibility to prevent that from happening.”