Which Lebanon-area hospitals prevent infections?

Facilities meet national baselines in most — but not all — cases

It can start as tenderness, pimples or a fever — and result in anything from an inconveniently long hospital stay to death.

Healthcare-associated infections (HAIs) annually cause the deaths of nearly 100,000 people and cost the healthcare industry tens of billions of dollars nationwide, according to state and federal agencies. And they “can often be prevented if hospitals follow best practices for treating patients,” according to Medicare.gov.

A recent report from the Centers for Disease Control and Prevention showed Pennsylvania hospitals beating national baselines for preventing infections, and hospitals in the Lebanon area are also generally performing well, according to Medicare data.

However, experts said there is room for improvement.

Red flags at Reading 

While hospitals in or near Lebanon County generally performed at or above national baselines, Reading Hospital performed statistically worse in two areas, according to Medicare.gov: Surgical site infections from colon surgery (SSI: Colon) and catheter-associated urinary tract infections (CAUTIs) in ICUs only.

Officials from Reading Hospital pointed out that the reporting period used to calculate those statistics was from April 2014 to March 2015, and they said there has been a “dramatic” decline in their infection rates since the beginning of 2015. In fact, Reading Hospital had a five month period starting in April 2015 in which there were no CAUTI infections in ICUs, said David Schlappy, the facility’s vice president and chief quality and transformation officer.

Reading Hospital has teams focused on reducing infections, has redoubled its efforts to reduce catheter-related infections by removing catheters quickly, and is providing precise weight-based doses of antibiotics, something that can help prevent colon surgery infections, officials said. The hospital also did statistically better than the national baseline in two categories: central line-associated blood stream infections in ICUs only and MRSA.

Comparing hospitals

Medicare.gov presents data in a manner designed to facilitate comparisons of hospitals. However, it can be challenging for the average person to account for variables like sample size and know how to use the data on HAIs to evaluate a hospital, said Erik Muther, managing director of the Pennsylvania Health Care Quality Alliance.

“This is one of the last quality measurement areas (in health care) that hasn’t been translated into a scheme that is understandable to most people,” Muther said.

In most categories, WellSpan Good Samaritan Hospital in Lebanon had two or fewer reported infections between April 2014 and March 2015 but did not have a large enough sample size to be evaluated as better or worse than the national baseline.

Robert Shaver, the hospital’s vice president of medical affairs, said the best way for people to evaluate a hospital for HAIs is to look at whether or not they are improving over time.

“I think what that suggests is a system or an institution that is engaged, and improvement is important to them,” Shaver said.

Year-to-year comparisons are available in an annual report at the Pennsylvania Department of Health website. Good Samaritan Hospital shows a trend of improvement between 2010 and 2014 in that report, while Reading Hospital’s data indicates a downward trend — although data is available only through 2014, before Reading Hospital officials said they began seeing substantial improvement in 2015.

Both Muther and Reading Hospital Senior Vice President and Chief Medical Officer Gregory Sorensen encouraged people to use hospital quality data as a tool to discover potential problems, but to ask if the institution has an explanation before assuming it is doing poorly.

“Shoot for zero” 

There used to be “general skepticism” in the healthcare community that infections could be completely eliminated, but some hospitals in recent years have documented infection rates of zero. As a result, healthcare professionals have become convinced that a small but nonzero number of infections should not be considered acceptable, Sorensen said.

Shaver said it’s probably still not possible to avoid all infections, “but like I tell my kids, if you’re not setting your goals high enough, you’re never going to reach them. We take the approach, like a lot of systems, that we need to shoot for zero.”

Andrew Resnick, Chief Quality Officer at Penn State Hershey Medical Center, said the hospital has achieved rates better than the national average for many HAIs largely by creating a culture focused on preventing infections. Rates can be curbed by something as simple as having healthcare workers wash their hands regularly, Resnick said.

While the hospital hasn’t completely eliminated infections, they are taken so seriously that staff on every unit can tell you when the last infection occurred on that unit, Resnick said.

“It takes a huge culture of accountability and trying to be a top performer,” he said.

Ways to prevent hospital infections

Here are several steps hospitals and patients can take to curb infection rates, according to experts:

• “Antibiotic stewardship.” Unnecessarily high doses of antibiotics allow bacteria to mutate and become resistant, according to David Consuelos, senior vice president for clinical integration at the Hospital and Healthsystem Association of Pennsylvania. There are several collaborative efforts taking place across the state to educate providers and patients about “using the right drug for the right bug.”
• Remove devices. People can’t get infections associated with catheters or central line equipment if they aren’t wearing them, said Robert Shaver at WellSpan Good Samaritan Hospital. So the hospital tracks patients on a day-to-day basis and removes them as soon as it is medically appropriate to do so.
• A clean environment. Good Samaritan extends its focus on the importance of preventing infections to even its housekeeping staff, emphasizing that they are part of the team working to keep patients healthy by maintaining clean rooms, Shaver said. Penn State Hershey Medical Center audits its environmental procedures regularly, an official said.
• Proactive patients. Patients coming to Good Samaritan for colon surgery are encouraged to clean their belly the night before the operation, and the hospital cleans it again before the surgery — a “layering effect” that can decrease infection risk, Shaver said. The Hospital and Healthsystem Association educates patients of the value of using antibacterial soaps and antibiotic ointments to clean themselves before a procedure, Consuelos said.

 

This article is part of a content-sharing partnership between Lebanon Daily News and WITF.  

A note of disclosure: Penn State Health and WellSpan Health underwrite this website.

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