Thanks to the reforms of Chapter 58 and Chapter 305, the Department of Public Health now conducts a regular review of efforts to control infection in Massachusetts hospitals. The department released its third annual report on the progress of hospitals in battling hospital-spread illness, and the overall message seems to be “slow but steady.”
The report primarily focuses on two litmus tests of the pervasiveness of infections: those spread by central line replacements in ICUs (central-line associated blood stream infections, or CLABSIs) and those spread in certain common surgical procedures (surgical site infections, or SSIs.) The department determined hospital progress in these areas by comparing hospital progress in reducing the spread of illness with predicted figures. In terms of CLABSIs, most types of ICUs hovered around the same proportion of infections. However, both pediatric and neonatal ICUs reported a significant reduction in illness spread by central lines.
Many types of ICUs were also making efforts to reduce usage of central lines, a critical step in curbing infection. Every insertion of a central line is a chance for infection to spread, so reports that neonatal, medical, medical/surgical, and burn ICUs had reduced utilization of central lines by more than 7% mark a promising path for further infection reduction. It’s also encouraging that Massachusetts continues to have infection rates which are significantly lower than national rates.
Reports on SSIs were mixed. Data from 2011 shows infection rates decreasing for coronary artery bypass and hip prosthesis procedures, but 2012 data is not available for these procedures yet. 2012 data focused primarily on hysterectomies. While abdominal hysterectomies had infection rates which were in line with predictions, vaginal hysterectomies ended up showing higher infection rates than predicted. A task force is at work to fight further infections.
Additionally, DPH released its June report on Serious Reportable Events (SREs), reporting statistics on serious errors in the medical setting through FY2011, along with predictions for 2012. Data from 2011 shows the most commonly reported SREs include falls resulting in death or serious disability (188), advanced pressure ulcers (bed sores, 70), a retained foreign object from surgery (33), and surgery to an incorrect body part (19). The report’s predictions for 2012 are relatively in line with data from 2011, but the department expects an increase in reports of serious medication error (16 predicted in 2012), which is likely related to last year’s outbreak of fungal meningitis.
The report demonstrates a continuation of a decrease in the incidence of serious medical errors. A good deal of this relates to improved hospital policy around falls and bed sores. However, the report also predicts an increase in SREs relating to surgery in 2012.
The transparency of this data helps patients around Massachusetts hold their hospitals accountable. You can check your local hospital’s number of SREs in each category from the first half on 2012 here, or read the full report from DPH here. You can also check how your hospital measures up with infection prevention here.