Francona on Hospital Acquired Infections

Many of us know someone who went into the hospital, picked up an infection and got sicker, rather than better. The Centers for Disease Control estimate this happens to 1.7 million Americans every year. In Massachusetts, the cost of treating these infections is as much as 473 million dollars annually. Better prevention has become a top priority for hospitals and government regulators. More on that after we hear the story of one man Red Sox fans know well.

BEBINGER: In October, 2002, Terry Francona had just finished a season as bench coach for the Texas Rangers. His knees were bothering him and his doctor recommended routine arthroscopies.

TERRY FRANCONA: I’d probably had six on each knee, it was no big deal, like an oil change. I walked out of surgery and was on my way home, thinking it was just another routine knee fixer upper. Little did I know that I was in for basically the fight of my life.

BEBINGER: A fight that began with staph infections in both knees. Staph is the common name for a group of bacteria that many people carry in their nose or on their skin. As Francona discovered, many strains don’t respond to commonly used antibiotics and are difficult to treat.

FRANCONA: I was in for four more surgeries, it was about a 7 week period when I was in and out of intensive care and I had some bleeding, almost lost a limb and at times my life was probably threatened. It was spiraling out of control and nobody has answers to get me back under control.

BEBINGER: Francona reminds himself now…he’s fortunate he survived.

FRANCONA: I laid in a hospital bed a lot of nights thinking, please let me be able to handle this, cause there were some nights when I didn’t think I could, the pain was pretty intense.

Then I’d try to remind myself, OK, you had a little bit of a problem and you move on, there’s a lot of people that haven’t been as fortunate. This hasn’t gotten in the way, it was just a bump in the road. Now it was a big bump, but that’s what it was and that’s the way I chose to look at it.

BEBINGER: Francona is working with the health care company, Covidien and a professional association on a national campaign called, “Strike out Infections.”

FRANCONA: Just trying to get the word out with infections, clean, cover protect. In our clubhouse here, our medical people are so conscientious; when machines are used they wipe them down. They use towelettes now, nothing is reusable anymore. Every wound is protected and maybe it just it sounds like common sense, but it’s something I didn’t know 6 years ago.

BEBINGER: And Francona has become a more assertive patient.

FRANCONA: I’m going in for back surgery when the season’s over and the doctor’s here, they laugh because I’m, there’s no, there can’t be a stupid question. I want to know what, why, when, where how; because it’s my body and my life and I have children and I think we all have a responsibility and a right to ask whatever questions we want.

BEBINGER: That’s the same message many hospital administrators are stressing as they fight hospital acquired infections.

KAREN NELSON: Hospitals are giving patients buttons that say, ask if I’ve washed my hands, wash your hands before you touch me, and that’s a real cultural change.

BEBINGER: Karen Nelson, the Senior VP for Clinical Affairs at the Massachusetts Hospital Association, says preventing hospital acquired infections is the association’s top priority. Hospitals in the Bay State and across the country are joining voluntary campaigns to stop these infections. They are also responding to pressure from patient safety groups and to new required state and federal reporting rules. The first state report on infection rates is expected next March.
Again, Karen Nelson.

NELSON: The philosophy has changed. All of us, years ago, including myself and I’m a nurse, used to accept hospital infections as just a normal part of health care. The science has shown us that is not true. Now we know that many if not most hospital acquired infections can be prevented. There is still debate about whether one can get to 0.

BEBINGER: The state is gathering information about who has Staph and which prevention methods are most effective. Last week, hospitals swabbed the noses of all intensive care patients to check for one type, MRSA. State Epidemiologist, Al DeMaria, says the results will help the Department of Public Health design a plan of attack.

AL DEMARIA: We think it’s going to show that some hospitals have a problem with MRSA at this moment in time and some don’t. So obviously it’s important not to make a recommendation that all hospitals do one thing when there’s so much diversity in the problem.

BEBINGER: DeMaria says the focus is on prevention because infections aren’t going away. MRSA and other complex infections have increased with the complexity of medical procedures.

DEMARIA: There are 18 different catheters that are inserted in 9 different ways in people with multiple different illnesses, there are antibiotics that we use that have all contributed to success in saving peoples lives, but the down side is that they are all associated with health care associated infections as well.

FRANCONA: The day I got to Spring training in February, I was wiped out, so it was a long fight back for me.

BEBINGER: Terry Francona has a few stories about how getting sick in the hospital affected his career in 2002, a year before he joined the Red Sox. He interviewed with 3 other clubs during that off season in when he was in and out of the hospital. A week after the initial surgery, he flew to Seattle to talk to the Mariners.

FRANCONA: That interview in Seattle, I had no business being there. I couldn’t breathe; I was sitting there holding my chest under the table. I don’t doubt that was a terribly impressive interview. It was awful, I was struggling.

BEBINGER: Which makes me wonder…if Francona had not been sick for most of the off-season in 2002…and had signed on to manage one of those other teams…would Red Sox fans still be asking…is this the year?

FRANCONA: (laughs) Well, I don’t know about that, I would rather have not gone through want I did physically. I’m glad I’m here. I love my job. Winning games in awesome, but helping people out and being part of something good also makes me excited.

BEBINGER: OK, Terry, but I’m convinced that your hospital acquired infection is a mention, if not a turning point in Red Sox history. Francona and many in the medical community are focused on making sure that the last thing a patient has to worry about when the go into a hospital is coming out in worse shape.