many times, with Eli recently attributing the death of Facts to be partly due to this big lie.
There are a couple of interesting recent developments on the GTZ front. First, one of the biggest promoters of the concept, APIC, appears to have expunged it from its website. Good thing I made screenshots of the old website for posterity's sake! Secondly, Paul Levy, a former hospital administrator, who writes the blog Not Running a Hospital, devoted a posting to GTZ yesterday. The title of the post is "Unethical and Shameful Behavior at the CDC." He blasts CDC and its director, Tom Frieden, for the use of the standardized infection ratio (a "meaningless methodology"), risk adjustment (he questions why medical school affiliation should impact infection rates), and the use of benchmarks (since zero is the goal). Unethical and shameful? Really?
The concept of Getting to Zero HAIs is at least 5 years old, and I find it amazing that I have yet to meet an infectious diseases physician (you know, those people that every day actually take care of patients with infections) who believes that HAI rates can be reduced to zero. Those of us in the reality-based community understand that when you immunosuppress patients as profoundly as we do, and use ever more invasive devices for ever longer durations of time, believing in Getting to Zero requires ingesting an awful lot of kool-aid. We certainly have to keep trying our best to reduce infections, but we also have to recognize that the advances in medicine are double-edged swords, and honesty requires that we acknowledge that infections will continue to occur despite our best efforts.
So kudos to APIC for moving on, and to CDC for the great work it does with not nearly enough resources.
Graphic: Jeffrey Sumber