Seven Georgia hospitals -- including four in metro Atlanta -- scored worse than the national benchmark for cases of potentially-deadly bloodstream infections.
Emory Midtown, Northside Hospital, Piedmont Henry Hospital and Southern Regional Medical Center all performed worse than their peers for rates of central line-associated bloodstream infections in intensive care units, according to new data released by the U.S. Centers for Medicare & Medicaid Services.
While some high-profile hospitals scored poorly, the majority of Georgia hospitals with enough cases to earn scores performed better than their peers on what's considered a key measure of patient safety.
About 1 in 4 patients who gets a central line infection will die as a result, making the condition one of the most serious of all healthcare-associated infections.
"Patients who go into a hospital deserve to be safe while they are there," said Dr. Michael Bell, deputy director of the CDC's Division of Healthcare Quality Promotion. "You shouldn't have to go in and come out with something worse than when you started."
Central lines are narrow tubes inserted into a large vein in a patient's neck or chest to provide medical care. Even though new research has shown that such infections are largely preventable, the CDC estimates that there were about 41,000 such infections in U.S. hospitals in 2009.
The release of the new infection data is important for consumers in Georgia. Unlike many other states, Georgia does not require public disclosure of hospital infection rates. The disclosure of the data on bloodstream infections in intensive care units is part of a federal effort that will give Georgians access to even more hospital-specific information in the years to come. The number of infections for each hospital is not revealed in the new data, just the score measuring each facility's performance against its peers.
The data is collected by the CDC's National Healthcare Safety Network and released by the Centers for Medicare & Medicaid Services (CMS) on its Hospital Compare website. Hospitals are currently sending in their data on catheter-associated urinary tract infections and surgical site infections to the CDC. That information will be made public next year.
The new CDC statistics are generally accepted by hospitals as the best statistics available for measuring infection rates.
The performance of Georgia hospitals varied in the new data. Even some hospitals operated by the same health system posted significantly different results. For example, Emory Midtown had an infection rate higher than similar hospitals, but Emory University Hospital on Emory's main campus scored better than its peers."Emory Healthcare is firmly committed to preventing healthcare-associated infections," Emory spokesman Lance Skelly said in a statement. "We know that we, and all healthcare providers, still have much to do."
Infections that patients get while undergoing medical treatment are one of the leading causes of death nationally. Treating a central-line associated bloodstream infection adds about $17,000 to the cost of a hospitalization.
Cobb County resident Tommy Newton welcomes the new focus on combating hospital-related infections. He takes this issue personally.
In 2006, his 23-year-old son underwent a heart valve replacement surgery at Emory. The surgery went well. But soon after the operation, T.J Newton got a fever. Tests later showed that T.J. had a catheter-associated urinary tract infection, Newton said. It was a MRSA infection that was resistant to antibiotics. The infection killed him.
"To be honest, when T.J. went into the hospital we didn't even know what MRSA was," Newton said. "Hospital-acquired infections -- I didn't know anything about them."
Emory declined to comment on the case or to confirm the facts.
Newton stops frequently at the cemetery where his son is buried."People say you get over it," Newton said. "But you don't get over it."
Newton is encouraged that hospitals are doing more than ever before to combat the infections.
For years, most experts believed that life-threatening infections were an unavoidable consequence of taking care of sick people. But research over the past decade has proven that the infections are largely preventable. Following prevention protocols means that hospitals have been able to cut infection rates not just slightly, but dramatically.
"Once you demonstrate that something like that is possible, it becomes overwhelmingly compelling to say that we must do this," said Bell, of the CDC.
The protocols for prevention are so effective that some hospitals have been able to go many months -- and even more than a year -- without a central line-associated bloodstream infection. WellStar Cobb Hospital's neo-natal intensive care unit, for example, has gone more than 700 days since its last such infection, WellStar said. Some hospitals in the new data reported zero infections in the first quarter of 2011.
"It's possible and that's what is new and different in the culture of healthcare -- the number we are trying to achieve is zero," said Dr. Leigh Hamby, Piedmont Healthcare's chief medical officer. Piedmont's flagship hospital in Buckhead scores better than similar hospitals in the new data. Piedmont Henry Hospital, which just joined the Piedmont system in January, scored worse than the benchmarks.
The slice of data released by CMS offers a limited picture of how well Georgia's hospitals are doing. The data covers only the first three months of 2011 and measures only one type of infection in one setting -- the ICU.
Experts cautioned against health care decisions based on the new data. But most said the numbers are worthy of study and can be used to ask hospitals and doctors what they are doing to prevent infections.
The public will eventually get access to a full year's worth of data measuring performance on numerous aspects of patient safety.
Northside Hospital spokesman Russ Davis said Northside "follows best practices" for infection control and that infections are rare. "In the timeframe that was examined in the category of the patients measured, the non-infection rate was 98 percent,” Davis said, in a statement.
Dr. Douglas Patten, senior vice president for medical affairs at Phoebe Putney Memorial Hospitalin Albany, said hospitals will benefit from having reliable, public data to track their own performance against others. Patten said that Phoebe Putney, which scored worse than the national benchmarks in the new data, said hospitals can learn from those who post the best results. "We're most interested in using the data to help us measure progress," he said.
Dr. Willie Cochran, Jr., chief medical officer at Southern Regional, which also posted a relatively high score, said the hospital has an infection-prevention team that has recently provided additional education to staff members. Recent results show a significant reduction in the central-line associated bloodstream infections, he said. Southeast Georgia Health System, whose Brunswick hospital had the worst rating among the Georgia hospitals scored, said it modified its approach to central lines and posted a much stronger score by the end of last year.
The Georgia Hospital Association last week launched its new Hospital Engagement Network -- a federally funded effort to coordinate projects aimed at reducing hospital-acquired infections and other conditions by 40 percent.
"You work in this area for so long and you see a little bit of improvement and a little bit of improvement and a little bit of improvement and you get kind of overwhelmed -- you really want to see some huge strides -- and I think that's what is going to happen now," said Vi Naylor, who oversees the association's patient safety programs.
Central line-associated blood stream infections
The Centers for Disease Control and Prevention is tracking the rate of central line infections in hospitals. Those infections stem from tubes inserted improperly — or unsanitarily — into a large vein of a patient’s neck or throat. Below is how metro Atlanta and Georgia hospitals with the highest infection rates fared. A “0” score means a hospital had no such infections. A score of “1” means a hospital’s infection rate was on par with its peers. Scores above “1” mean hospitals had a higher-than-predicted infection rate.
How Metro Atlanta fared
Hospital name City Score
DeKalb Medical Center Decatur 0
WellStar Kennestone Hospital Marietta 0.24
Piedmont Hospital Atlanta 0.27
Emory University Hospital Atlanta 0.28
Gwinnett Medical Center Lawrenceville 0.30
St. Joseph’s Hospital of Atlanta Atlanta 0.50
Eastside Medical Center Snellville 0.60
Atlanta Medical Center Atlanta 0.64
North Fulton Regional Hospital Roswell 0.72
Rockdale Medical Center Conyers 0.80
WellStar Cobb Hospital Austell 0.81
Northside Hospital Forsyth Cumming 0.83
Georgia hospitals with higher-than-predicted infection rates
Northside Hospital Atlanta 1.03
University Hospital Augusta 1.05
Piedmont Henry Hospital Stockbridge 1.19
Emory University Hospital Midtown Atlanta 1.24
Southern Regional Medical Center Riverdale 1.32
Phoebe Putney Memorial Hospital Albany 1.37
Southeast Georgia Health System-Brunswick Brunswick 2.01Source: Centers for Medicare & Medicaid Services, Centers for Disease Control and Prevention, Hospital Compare www.hospitalcompare.hhs.gov