Latest Consumer Reports ratings add categories for how well hospitals avoid passing along potentially deadly MRSA and C. diff infections — and many could stand to improve, it finds.
Many of the Seattle area’s largest and best-known hospitals may fall short when it comes to preventing patients from acquiring potentially deadly infections during their stays, a new analysis shows.
Of the region’s five biggest hospitals — including the University of Washington (UWMC) and Harborview medical centers — none achieved top ratings in Consumer Reports’ latest rankings, released Wednesday. All received low or middling scores both overall and for halting two newly added infections: C. diff and MRSA.
One high-profile hospital — Swedish Medical Center’s Cherry Hill campus — received the magazine’s lowest rating for avoiding infections overall, and the second-worst rating for stopping Clostridium difficile and methicillin-resistant Staphylococcus aureus infections.
“High ratings for MRSA and C. diff can be a red flag that a hospital isn’t following best practices in preventing infections and prescribing antibiotics,” said Doris Peter, director of Consumer Reports’ Health Ratings Center.
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An estimated 648,000 people in the U.S. acquire infections each year during hospital stays, and about 75,000 die, according to the latest figures from the Centers for Disease Control and Prevention (CDC). About 8,000 people die from MRSA infections each year, while C. diff claims more than three times that many — about 27,000 people.
But officials with individual hospitals and the Washington State Hospital Association (WSHA) were quick to counter that ratings published by groups such as Consumer Reports, while popular, aren’t necessarily the best way to evaluate quality or dedication to patient care.
“When patients see a rating in a magazine, they shouldn’t think that it’s the definitive word on patient safety, because it’s not,” said Mary Kay Clunies-Ross, spokeswoman for the WSHA.
The measures may include patients who come to hospitals already infected, boosting the number of cases, said Dr. Tim Dellit, associate medical director for infection control at Harborview Medical Center.
“It doesn’t take away from the fact that these are significant infections and all of us in health care are focused on these measures,” he said. “But I don’t think this is the only piece of information (patients) should use to make their decision.”
The Consumer Reports rankings were based on hospital reports sent to the Centers for Medicare and Medicaid Services (CMS) between October 2013 and September 2014, the latest figures available.
They report results based on a five-point scale rating hospitals from best (zero infections) to worst (more than 100 percent worse than the national baseline set by the CDC). The national baseline is the number of infections expected to occur at hospitals in the country based on data reported for a specific period to the National Healthcare Safety Network.
UWMC received a middle rating for avoiding infections overall, but the second-worst rating for stopping C. diff and MRSA. Harborview received the second-worst rating overall, including a middle-rating for avoiding MRSA, a low rating for stopping MRSA and Consumer Reports’ worst rating for avoiding surgical-site infections.
Some hospitals posted particularly low scores. At St. Joseph Medical Center in Tacoma, the MRSA rate was 186 percent worse than the national baseline. At Swedish Medical Center’s Cherry Hill site, the rate for catheter-associated urinary-tract infections in the intensive- care unit was 290 percent worse than the baseline.
Swedish officials declined an interview about the poor infection rates. But Dr. Michael Myint, vice president of quality and safety, noted in an emailed statement that the Consumer Report data is two years old and said that the hospital system has taken recent steps to improve infection control.
“As an example of the improvements, our CAUTI (catheter-associated urinary-tract infection rate in the ICU) was less than half the rate in the first six months of 2015 than it was during first six months of 2014,” the statement said.
A few regional hospitals reported zero cases of certain infections, but because the volume was so low, the results were not statistically better than baseline rates. Nationwide, 322 hospitals reported no MRSA infections, 357 had no C. diff infections — and 105 avoided both, the new report said. There are nearly 5,000 community hospitals in the U.S., according to the American Hospital Association.
Overall, these types of rankings do make hospitals take notice, said Dr. Mark Adams, chief medical officer for CHI Franciscan Health, which operates St. Joseph and several other state hospitals that posted concerning scores. He said he would be reviewing the new results with individual sites.
“No one likes to see black dots in Consumer Reports and we’re no different than anyone else,” he said. “We pay attention to it.”
Over time, attention sparked by various ratings may pay off, said Annemarie Flood, an infection prevention expert at City of Hope hospital in Los Angeles and chair of the public-policy committee for the Association for Professionals in Infection Control and Epidemiology. Many hospitals in Seattle and across the nation achieved high marks in avoiding deadly central-line infections, a marked improvement from previous years.
“Understanding what the issue is and then implementing evidence-based practices is what infection preventionists do every day,” Flood said.
There are specific steps patients and their families can take to decrease their chances of contracting an infection during a hospital stay, experts said.
First, question the use of antibiotics. Germs are increasingly becoming resistant to the top drugs used to treat infections. That’s the reason MRSA and C. diff infections have become so common — and so deadly.
“Everybody needs to think long and hard before they take an antibiotic,” said Karen Koch, quality administrator for the MultiCare Health System.
Second, check out your own hospital’s performance on the WSHA’s Hospital Quality site, which lets patients compare providers.
Finally, insist on a clean hospital room. “If the room doesn’t look clean, it should be cleaned,” Flood said.
Rankings like those published by Consumer Reports are most helpful for raising awareness of the larger issues, she added.
“Rather than focus on one bug, we should focus on all of the procedures and make sure that we’re doing the best that we can.”