Hospital-Aquired Infection Rates Go Public
Results of the state’s first-ever public report of hospital-acquired infections show Oregon facilities outperform the national average
Rates of central line blood stream infections in Oregon were 38 percent below the national average with 26 hospitals having reported none at all.
Infections after coronary bypass surgery were also down about 30 percent off the national average, while rates of infection after knee replacement surgery were similar to the national average.
As for the MRSA microorganism that’s especially hard to treat, there were 17 cases in 2009.
In all, 199 infections were reported last year to the state in the first year of the program managed by the Office of Health Policy and Research and the Oregon Health Authority. The program was created by the Oregon legislature in 2007.
Data submitted by hospitals have so far not been independently verified, though a team plans to audit the results by the end of next year. A preliminary review, and experience in other states, showed that what hospitals are reporting could be less than half of actual cases.
Before posting the results, state officials sought review and feedback from hospital administrators who made 60 corrections and/or comments regarding the data, mostly from facilities with scores less favorable than they would have liked. Overall, results were mixed with wide differences among some.
McKenzie-Willamette Medical Center, a for-profit rarity in the state, reported levels of blood stream infections nearly twice the national average as well as higher than average rates of infection from coronary bypass grafts.
In owning up to the report, hospital officials sent the following explanation, which appears in an appendix to the report: “The hospital experienced an increase in central line associated bloodstream infections in the intensive care units. A patient care improvement team was formed. We have made improvements that have resulted in a decrease in infections.”
A similar team tackled coronary artery bypass grafts at McKenzie-Willamette and have reduced infections to zero since the second quarter of 2009, according to the hospital.
Oregon Health & Science University also explained higher than average infection rates, reminding readers that it serves as a teaching institution and treats some of the toughest cases. In comments to the report, the hospital reinforced its pledge to eliminate preventable infections, while also casting some doubt on the data.
“These data may not be adequately risk stratified (adjusted) to reflect the complexity of the OHSU patient population,” according to public comments submitted by OHSU. “For example, many OHSU patients undergoing coronary artery bypass grafting require concurrent heart valve replacement, which may increase the risk for infection.”
Legacy Health System’s Jodi Joyce, vice president of quality and patient safety, explained some of its higher than average scores in a previous article at The Lund Report.
“The fact we’ve been doing this work across all of our hospitals instead of just our intensive care units has meant that in some places we haven’t yet made all of the improvements available,” Joyce said.
Dr. Steve Gordon, chief quality officer for PeaceHealth in Eugene and a member of the quality committee of the Oregon Association of Hospitals and Health Systems, called the report an important first step.
“The hospital association has been partnering with the OHPR from the beginning to bring this report forward in a meaningful fashion and use it as a foundation for continued prevention,” Gordon said.
But whether the report succeeded remains to be seen. “It’s important we hear back from consumers on whether this is helpful or useful,” Gordon said. “The intent is to be transparent.”
To read the full report click here.
For related article on hospital-acquired infections click here.
The following comes from a press release sent out by OHPR today:
Oregon is one of 10 states in the country with a mandatory statewide public reporting program for healthcare acquired infections. All hospitals are required to report three of the most common infections: central line-associated bloodstream infections, those that occur after knee replacement surgery, and those connected with coronary bypass grafts.
In 2009, there were 199 reported infections from 50 hospitals. The infection rate breaks down as follows:
-
The Oregon infection rate for central line-associated bloodstream infections is 1.2 infections per 1,000 central line days, approximately 38 percent lower than the national average of 1.92. (A central line is a catheter inserted directly into a large vein, which enables rapid administration of fluids, blood or medications.)
-
The Oregon coronary bypass graft infection rate is 2.01 percent, approximately 30 percent lower than the national rate of 2.86 percent.
-
The Oregon knee replacement infection rate is 0.82 percent, which is similar to the national rate of 0.89 percent.
“Healthcare acquired infections can be serious and costly. They are also largely preventable,” says Tina Edlund, deputy director of the Oregon Health Authority. “This information gives us a place to start as we improve patient safety. We are working closely with our partners in the healthcare community and patient advocates to do as much as possible to eliminate these infections.”
Healthcare acquired infections are among the top 10 leading causes of death in the United States and cost some $33 billion per year nationally. In Oregon, the cost per stay for patients who experience healthcare acquired infections increases an average of $32,000.
Preventing these infections has become a key element in improving patient care and lowering costs in the healthcare system. Hospital infections are a national problem. In 2011, federal health reform will begin requiring national reporting of infections and Medicare will stop reimbursing providers for costs associated with treating them.
“Addressing the issue takes effort on two fronts, improving patient care and improving patient education,” says Edlund.
Healthcare providers are increasing improvement and awareness of the issue. Several Oregon hospitals are participating in projects that address training and practices for hand hygiene, peer accountability and improved practices. The Oregon Association of Hospitals and Health Systems (OAHHS) coordinates several patient-safety clinical projects to specifically address hospital infections with its hospital members. More information can be found online at www.oahhs.org/quality.
"Oregon's hospitals are committed to working in a transparent way to eliminate all healthcare acquired infections in our state. Patient safety is our number-one responsibility," said Dr. Steve Gordon, member of the OAHHS Quality Committee and chief quality officer for PeaceHealth Oregon. "This first report illustrates that, although Oregon is ahead of national averages in terms of reducing healthcare acquired infections, there is still much more work to be done. Addressing HAI is a top priority of every hospital in this state."
Additionally, patients can reduce the risk of infection by taking all the pre-hospitalization infection prevention steps their doctors recommend, such as pre-surgical chlorhexidine baths, not shaving before surgery and stopping smoking. They should also take antibiotics and other medications exactly as directed by their doctors, and ask their visitors to stay home if they are sick.
The first Oregon Healthcare Acquired Infections Report stems from legislation passed in 2007 to create a mandatory reporting program to raise awareness, promote transparency for healthcare consumers and motivate healthcare providers to prioritize prevention. The Oregon Health Authority’s Health Care Acquired Infection Advisory Committee is working to expand the program in hospitals and is collecting information in other surgical facilities beyond hospitals.
The report, completed by the Oregon Health Authority’s Office for Health Policy Research, is available here.To learn more about health reform work under way in Oregon, go to www.Oregon.gov/OHA.
Bookmark/Search this post with
Keywords:
Printer-friendly version
Comments
Post new comment