The best, worst teaching hospitals on central line infections

Consumer Reports’ analysis on hospital-acquired infections found some “sobering" results when it came to teaching hospitals, with 31 making its list of low-performing facilities.

Based on five years of data from more than 2,000 hospitals, the report said there has been improvement on infections derived from bacteria within central lines, but “progress is slowing,” with some of the nation’s most prominent academic hospitals being given low scores.

“That’s counterintuitive,” said Doris Peter, PhD, director of the Consumer Reports Health Rating Center. “They are supposed to be places that represent the best in our healthcare system.”

Among the well-known institutions on the lowest-performing list were Atlanta Medical Center, Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, George Washington University Hospital in Washington, D.C., Ronald Reagan UCLA Medical Center in Los Angeles and SUNY Downstate Medical Center University Hospital in Brooklyn, New York.

SUNY Downstate was singled out in the report for having a central line infection rate “two times worse than the historic average” after being near the national target in 2014.

There is hope for hospitals to lower those rates, as evidenced by Shore Medical Center near Atlantic City, New Jersey.

As detailed in the report, Shore CMO Jeanne Rowe, MD, launched an effort to turn around the hospital’s status as one of the worst in preventing central line infections. When she took over in 2012, there had been eight infections among patients in the prior 12 months and was at risk of lowered Medicare reimbursement if it didn’t improve.

Using a checklist developed by Peter Pronovost, MD, now senior vice president for patient safety and quality at Johns Hopkins Medicine, hand-washing was emphasized among staff, extra soap and alcohol gel dispensers were installed, and nurses swabbed every patient’s skin before inserting central lines, and again when the dressing needed changing.

Those efforts, along with a secret team monitoring staff who broke the protocol, have worked. Shore has gone 21 months without a single central line infection among its patients.

Among the other high-performing hospitals were Mount Sinai St. Luke’s-Roosevelt in New York, New York, OhioHealth Riverside Methodist Hospital in Columbus, Ohio, San Francisco General Hospital, UC Irvine Medical Center and University of Chicago Medical Center.

To make certain the improvements don’t stop, the report called for federal regulators to do more than reduce Medicare payments to infection-prone hospitals.

“We think there are many requirements that could keep patients safe,” said Lisa McGiffert, director of Consumer Reports’ Safe Patient Project. “For example, the federal government should require hospitals to immediately report infection outbreaks or infection-control breaches to patients, healthcare providers, state and federal agencies, and the public. In essence, we’re saying that when there is an outbreak, if the hospital knows, then everyone should know.”