Consumer Reports looks at how well hospitals prevent common infectionsPosted on by
A new analysis finds big differences in hospital performance against C. diff and MRSA infections.
Guest Author: Teresa Carr
Senior Editor, Best Buy Drugs
An estimated one in 25 patients develops at least one infection while in the hospital, according to the Centers for Disease Control and Prevention (CDC). But that number is a nationwide average. A new analysis from Consumer Reports found that the rate of infections due to dangerous—and even deadly—bacteria is much higher at some hospitals than others.
Since 2009, Consumer Reports has rated hospitals on a variety of safety and quality measures, such as readmission and mortality rates, as well as certain infections. But now Consumer Reports hospital Ratings also include information on infections due to MRSA (methicillin-resistant staphylococcus aureus) and C. diff (clostridium difficile) bacteria, based on data that hospitals submit to the CDC. Findings are published in the September issue of Consumer Reports
“We chose to focus on those infections because they are both common and deadly,” says Consumer Reports’ Medical Director, Orly Avitzur, M.D. Classified as an “urgent threat” by the CDC, C. diff sickens 290,000 Americans while in hospitals and other health care facilities or soon after their discharge; at least 27,000 of those people die within 30 days following their illness. MRSA kills more than 8,000 patients each year and sickens almost 60,000.
“High infection rates can be a red flag that a hospital isn’t following best practices in preventing infections and prescribing antibiotics,” Avitzur says. That could not only allow C. diff and MRSA to spread, but also turn the hospital into a breeding ground for other resistant infections.
One of the biggest surprises is how big a difference there is between hospitals, even in the same community. In Los Angeles, for example, the analysis shows some hospitals report few C. diff infections while others have rates that are much higher than average—all within a few miles of each other. And in Brooklyn, New York, we found a striking difference: one hospital was among our lowest rated hospitals for avoiding MRSA infections while another in the same area received high marks.
What good hospitals do
So how do highly rated hospitals do it? When we talked to staff members at those hospitals, two common themes emerged. First, all said they had an antibiotic stewardship program, often headed by a pharmacist trained in infectious disease, to make sure patients get the right drug, at the right time, in the right dose. Because broad-spectrum antibiotics increase the risk of C. diff, for example, programs that reign in unnecessary use of those drugs have succeeded in reducing infections.
Second, good hospitals all mentioned scrupulous attention to cleanliness, particularly hand washing. In fact, research shows that fastidious hand washing slashes rates of C. diff, MRSA, and other infections.
Steps such as those, plus federal mandates for some reporting of infections data, have already led to reduced rates of certain infections. Still, we at Consumer Reports think hospitals need to do more:
- Consistently follow the established protocols for managing antibiotic-resistant infections, such as using protections including gowns, masks, and gloves by all staff.
- Be held financially accountable. Already, hospitals in the bottom 25 percent of the government’s data at preventing certain complications now have Medicare payments docked 1 percent. But they should also have to cover all costs of treating infections patients pick up during their stay.
- Have an antibiotic stewardship program. That should include mandatory reporting of antibiotic use to the CDC.
- Accurately report how many infections patients get in the hospital. And the government should validate those reports.
- Promptly report outbreaks to patients, as well as to state and federal health authorities. Those agencies should inform the public so that patients can know the risks before they check into the hospital.
What patients can do
There are also several things patients can do to protect themselves from infection, both in the hospital and after they check out. Read more about those measures and see Consumer Reports’ most complete and current Ratings for more than 3,000 U.S hospitals.