But information about quality of care at individual hospitals still hard to find
by Meg Wingerter, KHI News Service
As part of a federal quality improvement effort, Kansas hospitals are reducing the odds that patients will get certain types of infections.
And while that effort provides information on hospital quality throughout the state, finding information about the quality of care at individual hospitals remains a challenge.
The Kansas Healthcare Collaborative runs a hospital engagement network that includes 106 of the state’s 133 hospitals. Through a federally funded program, hospitals in the network are working to reduce patient harm and hospital readmissions by sharing their best practices.
Network hospitals aimed for a 40 percent reduction in instances of patient harm from September 2015 to September of this year, said Michele Clark, the collaborative’s hospital engagement network program director. While hospitals in the network weren’t able to reduce all types of patient harm by that much, infections related to central lines that deliver medication and fluids fell 55 percent and urinary tract infections from catheters were down 28 percent, she said.
Early scheduled births without a medical reason also were down, reducing the odds of infants developing health problems from being born too soon.
The collaborative estimated that Kansas hospitals avoided about 230 instances of patient harm, along with about $1.6 million in costs related to treating those patients if they had become infected or been harmed in another way.
“Overall it was deemed a great success,” Clark said.
Next round focuses on innovation
The efforts were part a nationwide push involving 3,700 hospitals, which federal officials estimated prevented about 34,000 instances of harm and saved about $288 million.
The Centers for Disease Control and Prevention estimated that infections patients pick up in hospitals cost anywhere from $28 billion to $45 billion annually. Those amounts vary widely because the CDC must estimate direct costs of treating infections and indirect costs like lost productivity when a patient can’t return to work.
Many of hospital engagement network participants, including the Kansas collaborative, also will participate in a hospital improvement innovation network as part of the next round of quality improvement projects.
The goals for the round starting this fall include decreasing instances when patients are harmed by 20 percent over the next two years and reducing hospital readmissions by 12 percent.
Hospitals also will work to reduce their rates of sepsis and C. difficile, Clark said. Sepsis is a life-threatening condition when the body’s attempts to fight an infection can cause organ failure, and C. difficile is a notoriously hard-to-treat intestinal infection.
The hospital engagement network’s emphasis on hospitals working together to reduce harm to patients has led to broad-based improvements, Clark said. She said she expects a few more Kansas hospitals to join the new network, and those that don’t join still can participate in educational activities like webinars.
“The whole purpose of the (network) is to make sure that patients receive the best and safest care wherever they go,” she said. “I think the work we’re doing in each facility is floating the boat of our health care system.”
Still little local hospital data
Despite the promising results from the hospital engagement network, Kansans don’t have an easy time finding out if the quality of care at their local hospital has improved, particularly if they live in rural areas.
Not all hospitals participating in the hospital engagement network reported all measures — primarily because they don’t all perform the same procedures, said Janie Rutherford, spokeswoman for the collaborative. Because 27 Kansas hospitals aren’t participating in the collaborative’s hospital engagement network, they weren’t included in the aggregated data.
The state and federal governments also don’t collect data from all hospitals.
The Kansas Healthcare-Associated Infections Advisory Group, which is made up of Kansas Department of Health and Environment officials and experts from private organizations, receives monthly reports on hospital infections from the CDC, state epidemiologist Charlie Hunt said.
It then uses that data to identify hospitals that need help addressing infections. The advisory group recently succeeded in helping hospitals bring down their rates of C. difficile, he said.
“If we see a significant increase in infections in a particular hospital, we would contact that hospital and see what’s going on,” he said. “It’s a classic principle that you manage what you measure.”
The CDC reports also are voluntary, however, and not all Kansas hospitals submit the information. Hunt estimated the advisory group receives data for about 95 percent of the hospital beds in the state. Most hospitals that don’t submit the infection information are small, he said.
Other federal measures also leave out quite a few Kansas hospitals. For example, CMS provides star ratings for 38 Kansas hospitals, but that leaves 95 without quality information.
The star ratings are controversial because it isn’t clear if they adequately account for how sick patients are and whether they can afford follow-up care. Still, the star ratings may give patients a rough idea of how likely they are to suffer harm by comparing a hospital’s safety data to the national average.
The result is that while Kansans may take comfort from knowing that the state’s hospitals as a whole are getting safer, they still have difficulty finding measures of the quality of care for their local hospital.
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