Infection rates & more

Maybe you saw the story in last Sunday’s Post-Standard ¹ about the annual report card on New York State hospitals that was issued by the Niagara Health Quality Coalition² The Coalition reports on mortality rates, blood clots after surgery, and hospital infections, using a risk-adjustment technique that makes for fair comparisons among hospitals, despite differences in the mix of patients they care for.

From the Coalition’s website, I collected comparison data on hospital infections for the four Syracuse hospitals and placed them in the accompanying chart. This shows hospital 2005 infection rates per 1,000 patients for infections occurring due to medical care (that is, primarily intravenous (IV) lines and catheters) and for postoperative sepsis (a bloodstream infection caused by toxin-producing bacteria occurring after surgery).

Naturally I was proud to see that CGH’s infection rates were below the state average and below the rates of other hospitals. In some cases our infection rates were one-half those of others. As the Coalition reports on its website: “Hospitals following the appropriate procedures, such as washing hands before working with a patient…should show a lower level of infections due to medical care³

May 2 was “Hand Hygiene Day” at CGH, and at the start of each shift hospital managers stood at each entrance to greet employees, volunteers, and physicians. They handed out more than 1,000 pocket-size bottles of Purell® that were donated to CGH by the company – to reinforce awareness about the importance of safe-hand practices here.

A number of people wore buttons reading, “Ask me if I washed my hands.” That is part of a campaign to encourage patients to be aware of (and to speak up about) hospital hand-washing practices and to discourage caregivers from being defensive when patients ask about hand-washing. As I wrote in last week’s letter,⁴ medical professionals have been more than a tad defensive about hand cleanliness for 150 years or so.

When a patient or family members asks, “Did you wash your hands,” the correct response is: “Thank you for asking. Yes, I did!” Or, “I am going to do that right now! Thank you for asking.”

And patients are speaking up. I recently received a letter from a patient who said, “I hate to beat a dead horse, but the only person I saw washing his hands was my attending physician (…kudos to him!) I think I saw my nurse do it, and I never once saw an aide do it. Now perhaps they did it down the hall or something, but…I want to make sure they have not touched anything (including and especially door handles) between the act of hand washing and doing anything to me (original emphasis).”

That’s Dennis Trepanier, Vice President – Operations, with volunteer Grace Easton and a supply of hand sanitizers on Hand Hygiene Day, May 2. Another patient wrote me to say she doesn’t trust hospitals so she brought to CGH her own supply of Clorox® wipes. During her stay she asked to speak with the Environmental Services management, and because of her concerns, a supervisor visited her several times during her stay, which she appreciated. The woman wrote me a very kind and complimentary letter about the staff who kept her room clean – but she did not hesitate to offer several pointed comments and observations about how we could improve our cleanliness.

Our patients are speaking up, and – with reports like that of the Niagara Coalition – more are likely to do so. Let’s encourage them to ask us about hand washing and infection control, and let’s be as responsive and as supportive as possible about cleanliness.

Thanks to the “green volunteers” who collected dozens of bags of litter from the CGH campus on Earth Day, May 3.From microorganisms to the environment, it’s been clean-up week at CGH. The day after Hand Hygiene Day, about 20 CGH “green volunteers” celebrated CGH’s own “Earth Day, May 3” by spreading out on the campus and picking up a season’s collection of discards and debris. It’s amazing what was found in parking lots, at the curbside, and along the tree line. The green volunteers filled dozens of trash bags with litter – cigarette butts, drinking cups, candy wrapper, old sneakers, glass and plastic bottles, plastic bags, car parts, and other detritus.

Thanks, everyone, for your ongoing help in keeping CGH clean – and safe.

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[1] “Hospital Report Card: Heart attack death rate high at University,” Post-Standard, April 29, 2007. For a copy of the story, go to: http://www.syracuse.com/poststandard/stories/index.ssf?/base/business-8/1177835843214811.xml&coll=1

[2] To see the report of the Niagara Coalition, go to: http://www.myhealthfinder.com/
(Click on “New York State Hospital Report Card” to find the area where you can compare hospital scores on 33 different measures.)

[3] http://www.myhealthfinder.com/newyork07/psi-full.php?table=07#REG

[4] “Weird, glowing substances,” April 28, 2007