New hygiene scheme to force hospitals to clean up

HOSPITALS will have to qualify for an annual hygiene certificate under a new quality control system beginning in the new year.

The measure is aimed at stamping out so-called super bugs like MRSA and restoring public confidence after an ad-hoc hygiene audit, carried out this time last year, found many hospitals were dirty.

A follow-up audit recorded substantial improvements in most hospitals but the Department of Health ordered a structured hygiene control scheme to be put in place to ensure standards were maintained.

Under the new scheme, teams of inspectors will make unannounced visits to all 52 of the country’s acute hospitals between March and May next year and make their findings public in a national report during the summer.

Each hospital will have the early months of 2007 to carry out its own self-assessment, rating itself on 57 areas of hygiene policy and practice, and submit a dossier on its performance to the Irish Health Services Accreditation Board (IHSAB).

The unannounced visits will check whether the self-assessment was accurate, highlight areas in need of improvement, and decide whether the hospital should receive its certificate.

An overall good rating will not be sufficient — the hospital will have to score top marks in 15 key criteria of the 57 listed to even be in line to qualify. The ratings will be measured as percentages and clustered as good, fair or poor. Hospitals will have to re-qualify each year.

Roisín Boland, chief executive of IHSAB, said the inspectors would work in teams of up to five and would spend up to three days in each hospital, but she was adamant their arrival date would be kept secret.

The inspectors will be recruited from a pool of professionals such as infection control specialists, directors of nursing and environmental health officers and may include personnel from Britain and Australia.

Hospitals that do not make the grade face no penalty other than to be named and shamed but Dr Mary Hynes, assistant director of the National Hospitals Office, said publicity was a powerful sanction.

“We are always going to be very open and transparent about the findings and that’s a very powerful incentive for hospitals to up their effort.”

Dr Hynes said while hygiene was essential for infection control, it was also crucial for public confidence in the hospital system. “If we go into a hospital and find it grubby, rightly or wrongly it puts a question in our head about the standard of service in that place. If we want to build trust with patients and families, it’s very important that we do it in a clean and hygienic environment.”

Unlike the previous audits which covered only public areas of hospitals, the new inspections will also examine operating theatres and kitchens. In the first hygiene audit last November, only five of the 53 hospitals inspected achieved a ‘good’ rating and 26 were ‘poor’ but that improved to 32 and 2 respectively in a repeat exercise in July this year.

IHSAB runs on an annual budget of €3 million and will be spending €600,000 on the hospital assessments.